Age And Comorbidity In Cancer Patients A Populationbased Approach

Maryska L.G. Janssen-Heijnen, Saskia Houterman, Valery E.P.P. Lemmens, Marieke W.J. Louwman, Jan Willem W. Coebergh

Maryska L.G. Janssen-Heijnen, Senior Researcher, Saskia Houterman, Staff Researcher, Valery E.P.P. Lemmens, Junior Researcher, Marieke W.J. Louwman, Senior Researcher, Eindhoven Cancer Registry at Comprehensive Cancer Center South (IKZ), 5600 AE Eindhoven, The Netherlands. Jan Willem W. Coebergh, Head of Research, Department of Public Health, Professor, Erasmus University Medical Centre Rotterdam, 3000 DR Rotterdam, The Netherlands.

The mean age of patients diagnosed with cancer is increasing in western countries due to rising incidence rates of most cancers with age and ageing of the population. In most European countries more than 40% of all new patients with cancer are over the age of 70, which implies that they increasingly suffer from one or more other serious (chronic) diseases and from interactions with and side effects from their treatment. Besides affecting the life expectancy co-morbid conditions and their treatment may complicate the clinical management of cancer patients, especially when they are frail. Since they are often excluded from clinical trials, little is known about treatment outcome, such as complications, quality of life and survival. Choice of curative treatment of cancer for older patients may be influenced by the physical condition of the patient (co-morbidity, reduced functional reserves, interaction between medications, performance status), the psychological condition (depression, dementia) and social parameters (informal care, mobility)1-3.

This chapter focuses on the role of age and co-morbidity in cancer patients. The value of studying co-morbidity is demonstrated by data of the population-based Eindhoven Cancer Registry 4. We were looking for answers on questions on guideline adherence from local clinicians who increasingly experienced problems with an increasing number of elderly patients. The clinical context is one of community hospitals only, within the framework of the Comprehensive Cancer Centre . We give insight in the prevalence of co-morbidity in unselected cancer patients, and the effects of co-morbidity on treatment and prognosis.

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