The complex health profile of long-term cancer survivors: prevalence and predictors of comorbid conditions
The complex health profile of long-term cancer survivors: prevalence and predictors of comorbid conditions
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DOI：
10.1007/s11764-014-0403-1
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发表时间：
2015-06-01
影响因子：
3.7
通讯作者：
Rowland, Julia H.
中科院分区：
文献类型：
--
作者：
Leach, Corinne R.;Weaver, Kathryn E.;Rowland, Julia H.
成年癌症幸存者具有复杂的医疗状况，其中可能包括癌症以外的慢性疾病。很少有研究检查癌症诊断前后合并症的患病率。从加州两个癌症登记处对癌症病例进行抽样，通过社会人口统计学、癌症相关和健康行为变量来检查 1,527 名长期乳腺癌、前列腺癌、结直肠癌和妇科癌症幸存者的医疗状况（癌症后经历和发展的情况）。平均而言，幸存者报告了五种曾经诊断过的医疗状况（95% CI，4.8，5.1）和1.9 种癌症后诊断的病症（95% CI，1.8，2.0）。乳腺癌幸存者报告的合并症负担最高（曾经为 5.8，癌症后为 2.9），前列腺幸存者报告的合并症负担最低（曾经为 4.0，癌症后为 1.0）。较高的合并症负担与年龄较大、乳腺癌幸存者、离婚、丧偶或分居、非西班牙裔白人、超重或肥胖以及未接受化疗有关。乳腺癌和子宫内膜癌幸存者，以及诊断后 10 年以上、肥胖或缺乏运动的人更有可能报告这些合并症发生在癌症之后。癌症治疗类型、吸烟、年龄、种族/民族、婚姻状况和教育程度并不是癌症后合并症的显着预测因素。癌症幸存者报告了大量的医疗状况，其中许多是在癌症诊断后发现的。研究结果表明，癌症诊断后的时间、体重指数和活动水平是管理幸存者治疗后随访护理时的重要背景变量。当健康专业人员建议实现健康体重和定期体育活动的具体策略，以实现癌症后更好的长期健康结果时，幸存者可能会受益。
Adult cancer survivors have complex medical profiles that may include chronic conditions beyond cancer. Few studies have examined the prevalence of comorbidities before and after a cancer diagnosis.Cancer cases were sampled from two California cancer registries to examine medical conditions (ever experienced and developed after cancer) among 1,527 long-term breast, prostate, colorectal, and gynecological cancer survivors by socio-demographic, cancer-related, and health behavior variables.On average, survivors reported five medical conditions ever diagnosed (95 % CI, 4.8, 5.1) and 1.9 conditions (95 % CI, 1.8, 2.0) diagnosed after cancer. Breast cancer survivors reported the highest (5.8 ever, 2.9 post-cancer) and prostate survivors the lowest (4.0 ever, 1.0 post-cancer) comorbidity burden. Higher comorbidity burden was associated with older age, being a breast cancer survivor, divorced, widowed or separated, non-Hispanic White, overweight or obese, and not receiving chemotherapy. Breast and endometrial cancer survivors, as well as those more than 10 years post-diagnosis, obese, or physically inactive were more likely to report that these comorbidities occurred after cancer. Cancer treatment type, smoking, age, race/ethnicity, marital status, and education were not significant predictors of comorbidities acquired post-cancer.Cancer survivors report a large number of medical conditions, many identified after a cancer diagnosis. Findings suggest that time since cancer diagnosis, body mass index, and activity level are important contextual variables when managing survivor's post-treatment follow-up care.Survivors may benefit when health professionals recommend specific strategies to achieve a healthy weight and regular physical activity for better long-term health outcomes after cancer.