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Comorbidities and perceived health status in persons with history of cancer in the USA

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Abstract

Purpose

Comorbidities can further challenge prognosis and general wellbeing of cancer patients. This study aimed to assess the association between comorbidities and perceived health status (PHS) of US persons with cancer.

Methods

This cross-sectional study used 2019 Medical Expenditure Panel Survey (MEPS) data and included individuals who were alive throughout the year, aged 18 to 84 years, and had diagnosis for cancer. Using adjusted logistic regression models, we estimated the association of comorbidities (no, few [1/2], and more [3 or more] comorbidities) with PHS. Analyses accounted for the complex design of MEPS.

Results

The dataset included 28,512 participants, 1739 of which were eligible for the study. Of these, 11.16% (95% CI 9.64, 12.59%); 41.73% (95% CI 39.21, 43.96%); and 47.10% (95% CI 44.86, 49.73%) reported having no, few, and more comorbidities, respectively. While breast (N = 356), prostate (N = 276), and melanoma (N = 273) were the most common cancers, hypertension (88.3%), hypercholesterolemia (49.5%), and arthritis (48%) were the most prevalent comorbidities. Adjusted logistic regression showed that, compared with those with no comorbidities, persons with few and more comorbidities had 1.58 (95% CI = 0.79, 3.15) and 2.27 (95% CI = 1.19, 4.32) times greater odds of poor PHS. Younger or male patients, those with less formal education, low-income, pain, functional limitation, or poor perception of mental health were more likely to regard their health as poor.

Conclusion

About 88% of persons with history of cancer in the USA aged 18–84 years reported at least one comorbidity. Having more comorbidities, along with several other variables, was associated with poor PHS. Comorbidities management must be given special consideration to improve the prognosis and general wellbeing of persons with cancer.

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Data availability

The datasets used for this study are from the publicly available MEPS database available at https://www.meps.ahrq.gov/mepsweb/.

References  

  1. National Center for Health Statistics, Heron M. Deaths: leading causes for (2018) [Internet]. National Center for Health Statistics; 2021. Available from: https://stacks.cdc.gov/view/cdc/104186 Accessed 15 Sept 2021

  2. Siegel RL, Miller KD, Jemal A (2018) Cancer statistics. A Cancer J Clin 68:7–30. https://doi.org/10.3322/caac.21442

    Article  Google Scholar 

  3. Roy S, Vallepu S, Barrios C et al (2018) Comparison of comorbid conditions between cancer survivors and age-matched patients without cancer. J Clin Med Res 10:911–919. https://doi.org/10.14740/jocmr3617w

  4. Fowler H, Belot A, Ellis L et al (2020) Comorbidity prevalence among cancer patients: a population-based cohort study of four cancers. BMC Cancer 20:2. https://doi.org/10.1186/s12885-019-6472-9

    Article  Google Scholar 

  5. Smith AW, Reeve BB, Bellizzi KM et al (2008) Cancer, comorbidities, and health-related quality of life of older adults. Health Care Financ Rev 29:41–56

  6. Shrestha A, Martin C, Burton M et al (2019) Quality of life versus length of life considerations in cancer patients: a systematic literature review. Psychooncology s28:1367–1380. https://doi.org/10.1002/pon.5054

  7. López Varela MV, Montes de Oca M, Halbert R et al (2013) Comorbidities and health status in individuals with and without COPD in five Latin American cities: the PLATINO study. Arch Bronconeumol 49:468–474

    Article  Google Scholar 

  8. Song X, Wu J, on behalf of the China Kadoorie Biobank Collaborative Group et al (2018) Association between multiple comorbidities and self-rated health status in middle-aged and elderly Chinese: the China Kadoorie Biobank study. BMC Public Health 18:744. https://doi.org/10.1186/s12889-018-5632-1

    Article  Google Scholar 

  9. Bhattacharjee S, Yegezu Z, Kollecas K et al (2021) Influence of comorbidities on healthcare expenditures and perceived physical and mental health status among adults with multiple sclerosis: a propensity score-matched US national-level study. CEOR 13:377–394. https://doi.org/10.2147/CEOR.S305154

  10. Greer JA, Pirl WF, Jackson VA et al. (2014) Perceptions of health status and survival in patients with metastatic lung cancer. Journal of Pain and Symptom Management 48:548–557. Available from: https://www.sciencedirect.com/science/article/pii/S0885392414000402

  11. Anderson RT, Eton DT, Camacho FT et al (2021) Impact of comorbidities and treatment burden on general well-being among women’s cancer survivors. J Patient-Reported Outcomes 5:2. https://doi.org/10.1186/s41687-020-00264-z

    Article  CAS  Google Scholar 

  12. Gallicchio L, Kalesan B, Hoffman SC et al (2008) Non-cancer adverse health conditions and perceived health and function among cancer survivors participating in a community-based cohort study in Washington County. Maryland J Cancer Surviv 2:12–19

    Article  Google Scholar 

  13. Medical Expenditure Panel Survey background. Available from: https://meps.ahrq.gov/mepsweb/about_meps/survey_back.jsp Accessed 15 Sept 2021

  14. Machlin S, Cohen J, Elixhauser A et al (2009) Sensitivity of household reported medical conditions in the medical expenditure panel survey. Medical Care 47:618–625. https://doi.org/10.1097/MLR.0b013e318195fa79

  15. Medical Expenditure Panel Survey topics. Available from: https://meps.ahrq.gov/mepsweb/data_stats/MEPS_topics.jsp?topicid=41Z-1 Accessed 15 Sept 2021

  16. Meduru P, Helmer D, Rajan M et al (2007) Chronic illness with complexity: implications for performance measurement of optimal glycemic control. J Gen Intern Med 22:408–418. https://doi.org/10.1007/s11606-007-0310-5

    Article  Google Scholar 

  17. Colinet B, Jacot W, Bertrand D et al (2005) A new simplified comorbidity score as a prognostic factor in non-small-cell lung cancer patients: description and comparison with the Charlson’s index. Br J Cancer 93:1098–1105. https://doi.org/10.1038/sj.bjc.6602836

  18. Vardy JL, Pond GR, Cysique LA et al (2022) Lack of cognitive impairment in long-term survivors of colorectal cancer. Support Care Cancer 30(7):6123–6133. https://doi.org/10.1007/S00520-022-07008-3/TABLES/5

    Article  Google Scholar 

  19. Shaw LM, Iseli TA, Wiesenfeld D, Ramakrishnan A, Granger CL (2021) Postoperative pulmonary complications following major head and neck cancer surgery. Int J Oral Maxillofac Surg 50(3):302–308. https://doi.org/10.1016/J.IJOM.2020.06.011

    Article  CAS  Google Scholar 

  20. Andersen RM (1995) Revisiting the behavioral model and access to medical care: does it matter? J Health Soc Behav 36:1–10

  21. Furrukh M (2013) Tobacco smoking and lung cancer. Sultan Qaboos Univ Med J 13:345–358. https://doi.org/10.12816/0003255

  22. Harding JL, Sooriyakumaran M, Anstey KJ et al (2016) Hypertension, antihypertensive treatment and cancer incidence and mortality: a pooled collaborative analysis of 12 Australian and New Zealand cohorts. J Hypertension 34:149–155. https://doi.org/10.1097/HJH.0000000000000770

  23. Mouhayar E, Salahudeen A (2011) Hypertension in cancer patients. Tex Heart Inst J 38:263–265

  24. Radišauskas R, Kuzmickienė I, Milinavičienė E et al (2016) Hypertension, serum lipids and cancer risk: a review of epidemiological evidence. Medicina 52:89–98. https://doi.org/10.1016/j.medici.2016.03.002

  25. Pundole X, Suarez-Almazor ME (2020) Cancer and rheumatoid arthritis. Rheumatic disease clinics of North America 46:445–462. https://doi.org/10.1016/j.rdc.2020.05.003

  26. Mohammed T, Singh M, Tiu JG et al (2021) Etiology and management of hypertension in patients with cancer. Cardio-Oncol 7:14. https://doi.org/10.1186/s40959-021-00101-2

    Article  Google Scholar 

  27. Al-Mandhari A, Al-Zakwani I, Al-Hasni A et al (2011) Assessment of perceived health status in hypertensive and diabetes mellitus patients at primary health centers in Oman. Int J Prev Med 2:256–263.

  28. Akbaş O, Tuncer Ö (2021) Assessment of the functional health status of hypertension patients in family medicine. Hamidiyemedj 2:13–19

  29. Ding X, Zhang W, Li S et al. (2019) The role of cholesterol metabolism in cancer. Am J Cancer Res 9:219–227. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6405981/

  30. Eton D, Anderson R, Cohn W et al (2019) Risk factors for poor health-related quality of life in cancer survivors with multiple chronic conditions: exploring the role of treatment burden as a mediator. Patient Related Outcome Measures 10:89–99

    Article  Google Scholar 

  31. Naughton MJ, Weaver KE (2014) Physical and mental health among cancer survivors. NC Med J 75:283–286. https://doi.org/10.18043/ncm.75.4.283

  32. Weaver KE, Forsythe LP, Reeve BB et al (2012) Mental and physical health-related quality of life among US cancer survivors: population estimates from the 2010 National Health Interview Survey. Cancer Epidemiol Biomarkers Prev 21:2108–2117. https://doi.org/10.1158/1055-9965.EPI-12-0740

  33. Su LJ, O’Connor SN, Chiang TC (2021) Association between household income and self-perceived health status and poor mental and physical health among cancer survivors. Front Publ Health 9:752868. https://doi.org/10.3389/fpubh.2021.752868

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Authors and Affiliations

  1. Department of Pharmacy Practice and Science, College of Pharmacy, University of Arizona, Tucson, AZ, USA

    Mavis Obeng-Kusi, Briana M. Choi & David R. Axon

  2. Concord Cancer Centre, Concord Repatriation & General Hospital, Hospital Rd, Concord, NSW, 2139, Australia

    Janette L. Vardy

  3. Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia

    Janette L. Vardy

  4. Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ, USA

    Melanie L. Bell

Authors
  1. Mavis Obeng-Kusi
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  2. Janette L. Vardy
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  3. Melanie L. Bell
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  4. Briana M. Choi
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  5. David R. Axon
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Contributions

All authors contributed to the study conception and design. Data analysis was performed by Mavis Obeng-Kusi and Briana Choi. The first draft of the manuscript was written by Mavis Obeng-Kusi and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Mavis Obeng-Kusi.

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Ethics approval

The study was approved by the University of Arizona Institutional Review Board (Number 34824; Date October 18, 2021).

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This was a retrospective analysis of publicly available survey data. The research did not involve human subjects who needed to consent.

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This was a retrospective analysis of publicly available survey data. The research did not involve human subjects who needed to consent.

Competing interests

The authors declare no competing interests.

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Obeng-Kusi, M., Vardy, J.L., Bell, M.L. et al. Comorbidities and perceived health status in persons with history of cancer in the USA. Support Care Cancer 31, 16 (2023). https://doi.org/10.1007/s00520-022-07479-4

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