Prevalence of co-morbidity in lung cancer patients and its relationship with treatment: A population-based study

Janssen‐Heijnen, M.L.G.; Schipper, Robert-Jan; Razenberg, P. P. A.; Crommelin, M. A.; Coebergh, Jan Willem

doi:10.1016/s0169-5002(98)00039-7

Cited by 276 publications

(209 citation statements)

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“…To record comorbidity, methods introduced by the adjacent cancer registry in Eindhoven (IKZ) were used. They have been recording comorbidity since 1993 and a validation project has been carried out [3]. To evaluate the data on comorbidity in the present study, the prevalence of comorbidity in lung cancer patients was compared to the outcomes of the IKZ study [3].…”

Section: Discussionmentioning

confidence: 99%

“…They have been recording comorbidity since 1993 and a validation project has been carried out [3]. To evaluate the data on comorbidity in the present study, the prevalence of comorbidity in lung cancer patients was compared to the outcomes of the IKZ study [3]. Differences were in a range of 1-6% for both men and women in seven out of eight categories.…”

Section: Discussionmentioning

confidence: 99%

“…Without comorbidity adjustment, it can be argued that any apparent age bias in decision making is only a reflection of the poorer general health of older patients. In earlier studies, effects were found even after adjusting for comorbidity [3] or performance status [4]. This strongly suggests that physicians are basing their decisions on calendar age rather than on biological age.…”

Section: Introductionmentioning

confidence: 92%

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Influence of age, comorbidity and performance status on the choice of treatment for patients with non-small cell lung cancer; results of a population-based study

et al. 2004

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SummaryBackground: In the Netherlands in 1997, 43% of patients with newly diagnosed lung cancer were over 70. Large age-specific differences in treatment exist. We examined whether age, comorbidity, performance status and pulmonary function influenced treatment. Patients and methods: Data on patients with newly diagnosed non-small cell lung cancer (N = 803) were obtained: comorbidity, performance status, pulmonary function (FEV1) and initial treatment. Age-specific differences in treatment according to the guidelines were examined. Odds ratios were calculated by means of logistic regression analyses. Results: 82% with stage I or II disease received treatment according to the guidelines; this applied to 48% with stage IIIA disease and to 54% with stage IIIB disease. For all stages, this proportion decreased with increasing age. In stage IV disease, 36% did not receive any treatment; this applied to 52% of the elderly patients (75 + years). Multivariate analyses showed associations between comorbidity and treatment choice, but none with performance status. Age of 75 + years appeared to be the most important factor for not receiving treatment according to guidelines. Conclusion:A substantial proportion of elderly patients with non-small cell lung cancer did not receive standard treatment. Performance status and comorbidity seldom formed the underlying reason. Calendar rather than biological age seemed to play the most important role in choice of treatment for patients with non-small cell lung cancer.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 92%

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Influence of age, comorbidity and performance status on the choice of treatment for patients with non-small cell lung cancer; results of a population-based study

et al. 2004

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“…It has been reported that, among individuals aged 65-74 years, the mean number of chronic diseases is six. The prevalence of these comorbid conditions is about twice as high in the elderly as in the general population [19]. Preliminary observations of cancer patients also confirm the coexistence of other diseases in elderly lung cancer patients [20].…”

Section: Biological Changes Associated With Agingmentioning

confidence: 58%

Treatment of Small Cell Lung Cancer in the Elderly

et al. 2005

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Small cell lung cancer (SCLC) accounts for approximately 20% of lung carcinomas. Chemotherapy is the cornerstone of treatment for SCLC. In limited disease, the median survival time is about 12-16 months, with a 4%-5% long-term survival rate; in extensive disease the median survival time is 7-11 months. More than 50% of lung cancer patients are diagnosed when they are over the age of 65, and about 30% are over 70. Elderly patients tolerate chemotherapy poorly compared with their younger counterparts, because of agerelated progressive reductions in organ function and comorbidities. The standard therapy for limited disease is combined chemoradiotherapy, followed by prophylactic brain irradiation for patients achieving complete responses. In the elderly, the addition of radiotherapy to chemotherapy must be carefully evaluated, considering the slight survival benefit and potential for substantial toxicity incurred with this treatment. The best approach is to design clinical trials that specifically include geriatric assessment to develop active and well-tolerated chemotherapy regimens for elderly SCLC patients. Survival improvement for SCLC patients requires a better understanding of tumor biology and the subsequent development of novel therapeutic strategies. Several targeted agents have been introduced into clinical trials in SCLC, but a minority of these new agents offers a promise of improved outcomes, and negative results are reported more commonly than positive ones. This review focuses on the main issues in the treatment of elderly SCLC patients. The Oncologist 2005;10:399-411The Oncologist 2005;10:399-411 www.TheOncologist.com

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“…Aging directly correlates with declining functional status and increased functional dependency. Aging is also associated with the increased likelihood of developing concurrent diseases, called comorbidities [13][14][15][16], and diseases which are typically linked to aging, known as "geriatric syndromes" [17][18][19][20][21]. Comorbidities complicate the overall health of the elderly and significantly increase with advancing age [22].…”

Section: Physiological Foundation Of Agingmentioning

confidence: 99%

Too Old to Care?

2004

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Shortly before his death in 1995, Kenneth B. Schwartz, a cancer patient at Massachusetts General Hospital (MGH), founded The Kenneth B. Schwartz Center at MGH (http://www.theschwarzcenter.org/rounds.asp). The Schwartz Center is a nonprofit organization dedicated to supporting and advancing compassionate health care delivery, which provides hope to the patient and support to caregivers, and encourages the healing process. The center sponsors the Schwartz Center Rounds, a monthly multidisciplinary forum where caregivers reflect on important psychosocial issues faced by patients, their families, and their caregivers, and gain insight and support from fellow staff members.Ageism is a pervasive problem throughout society. It is rooted in language, attitudes, beliefs, behaviors, and policies. Aging profoundly influences physiology, challenging the medical community to accommodate but not discriminate. The elderly are at an increased risk of disease and disability. Sixty percent of cancer occurs in people aged 65 and older, and the population is aging. The treatment of cancer in the elderly is complicated by comorbidities and other physiological factors, particularly renal, bone marrow, and metabolic reserve. Caregivers have to treat patients in a manner that optimizes treatment and avoids anticipated harm. However, the caregiver is often faced with situations where they must balance their personal beliefs, professional values, and knowledge of medicine with their patients' preferences and needs. Discussion in the Rounds focused on age bias, drug toxicity, life prolongation, and symptom relief, with the role of the caregiver, and the relationship to the patient, being pivotal. The Oncologist 2004;9:343-352 LEARNING OBJECTIVESAfter completing this course, the reader will be able to:1. Discuss the competing issues in the use of cytotoxic chemotherapy in older patients.2. Identify the intrinsic biases in evaluating the elderly.3. Explain how to inform patients in the face of uncertainty.Access and take the CME test online and receive 1 hour of AMA PRA category 1 credit at CME.TheOncologist.com CME CME CASE PRESENTATIONMrs. L, an 84-year-old woman, was undergoing rehabilitation after hip and wrist surgery when a mass in her lung was detected on a hospital admission chest x-ray. Evaluation of the mass revealed that it was small cell lung carcinoma. She had a cough, occasional hemoptysis, chest This material is protected by U.S.

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Prevalence of co-morbidity in lung cancer patients and its relationship with treatment: A population-based study

Cited by 276 publications

References 28 publications

Influence of age, comorbidity and performance status on the choice of treatment for patients with non-small cell lung cancer; results of a population-based study

Influence of age, comorbidity and performance status on the choice of treatment for patients with non-small cell lung cancer; results of a population-based study

Treatment of Small Cell Lung Cancer in the Elderly

Too Old to Care?

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