Prevalence of Comorbidity and Impact On Survival in Women with Lung, Breast and Cervical Cancer

Abstract

Madelaine Sarria Castro, Orlando Parellada Joa, Shivani Samlall, Juan Jesus Lence Anta, Priscila Torres Barbie, Solveing Rousseaux Lamothe, Eldier Rodriguez Herrera, Luis Eduardo Martin Rodriguez and Juan Mario Silveira Pablos

Background: The relationship between cancer incidence and mortality, and the resulting comorbidities of the elderly reflects current demographics trends Objective: The study aimed to investigate the prevalence of comorbidities and their impact on survival of women diagnosed with: NSCLC, breast and cervical cancer, at the National Institute of Oncology and Radiobiology in Havana, Cuba.

Methods: Data were collected retrospectively from patients' clinical charts. The study involved 138 NSCLC, 1 598 breast cancer and 631 cervical cancer registered during 2007-2011. Comorbidity was classified according to the ICD-10 diagnosis code and was measured using Charlson Comorbidity Index. Associations between comorbidities and mortality by all causes were analyzed in Cox regression models.

Results: The highest prevalence of comorbidities was in NSCLC (68.8%). The 3-year OS for NSCLC were 44.5% (95%CI: 29.3–59.7) and 23.3% (95%CI: 13.2–33.4) in patients without and with comorbidity, respectively (p=.01). The 5-year OS for breast cancer in the no comorbidity group was 91.4% (95%CI: 89.6–91.6) compared with 37.2% (95%CI: 32.7-59.9) in the comorbodity group (p=.00). The 5-year OS for cervical cancer in patients without diseases was (55.8% [95%CI: 50.7 – 59.9]), in women with comorbidity (27.7% [95%CI: 15.9–29.5]) (p =.00). Comorbidity was an independent predictor for overall survival: NSCL (HR Adjusted: 2.28 [95%CI: 1.43 - 3.65], p=.000), breast cancer (HR Adjusted: 3.16 [95%CI: 2.69–3.71], p=.000), cervical cancer (HR Adjusted: 1.38 [95%CI: 1.10–1.86], p=.032)

Conclusions: Comorbidity is an important prognostic factor for women diagnosed with lung, breast and cervical cancer.

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