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Comorbidities in lung cancer: prevalence, severity and links with socioeconomic status and treatment
  1. Derek Grose1,
  2. David S Morrison2,
  3. Graham Devereux3,
  4. Richard Jones1,
  5. Dave Sharma4,
  6. Colin Selby5,
  7. Kirsty Docherty4,
  8. David McIntosh1,
  9. Greig Louden6,
  10. Marianne Nicolson7,
  11. Donald C McMillan8,
  12. Robert Milroy9,
  13. on behalf of the Scottish Lung Cancer Forum
  1. 1Department of Clinical Oncology, Beatson Oncology Centre, Glasgow, UK
  2. 2Department Public Health, University of Glasgow, Glasgow, UK
  3. 3Department of Child Health, University of Aberdeen, Aberdeen, UK
  4. 4Department of Respiratory Medicine, Inverclyde Royal Hospital, Inverclyde, UK
  5. 5Department of Respiratory Medicine, Queen Margaret Hospital, Dunfermline, UK
  6. 6Department of Internal Medicine, Wishaw General Hospital, Wishaw, UK
  7. 7Department of Oncology, Aberdeen Royal Infirmary, Aberdeen, UK
  8. 8Department of Surgery, University of Glasgow, Glasgow, UK
  9. 9Glasgow Royal Infirmary, Glasgow, UK
  1. Correspondence to Dr Derek Grose, Department of Clinical Oncology, Beatson Oncology Centre, Glasgow G12 OYN, UK; derek_grose{at}hotmail.com

Abstract

Background Survival from lung cancer remains poor in Scotland, UK. Although the presence of comorbidities is known to influence outcomes, detailed quantification of comorbidities is not available in routinely collected audit or cancer registry data. The aim of the present study was to assess the prevalence and severity of comorbidities in patients with newly diagnosed lung cancer across four centres throughout Scotland using validated criteria.

Methods Between 2005 and 2008, all patients with newly diagnosed lung cancer coming through the multidisciplinary teams in four Scottish centres were included in the study. Patient demographics, WHO/Eastern Cooperative Oncology Group performance status, clinicopathological features and primary treatment modality were recorded.

Results Details of 882 patients were collected prospectively. The majority of patients (87.3%) had at least one comorbidity, the most common being weight loss (53%), chronic obstructive pulmonary disease (43%), renal impairment (28%) and ischaemic heart disease (27%). A composite score was produced that included both number and severity of comorbidities. One in seven patients (15.3%) had severe comorbidity scores. There were statistically significant variations in comorbidity scores between treatment centres and between non-small cell lung carcinoma treatment groups. Disease stage was not associated with comorbidity score.

Conclusions There is a high prevalence of multiple, severe comorbidities in Scottish patients with lung cancer, and these vary by site and treatment group. Further research is needed to determine the relationship between comorbidity scores and survival in these patients.

Keywords
  •  Lung cancer
  • epidemiology
  • comorbidity

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