CANCER AND COMORBIDITY IN OLDER PATIENTS - A DESCRIPTIVE PROFILE

In 1992, the National Institute on Aging (NIA) and the National Cancer Institute (NCI) initiated a study to assess the prevalence of comorbi d conditions in elderly patients with cancer. Seven cancer sites were selected for the study: breast, cervix, ovary, prostate, colon, stomac h, and urinary bladder. This report on similar to 7600 patients in the study sample describes the NIA/NCI approach to developing information on comorbidity in elderly patients and addresses the chronic disease burden (i.e., comorbidity) and severity for six particular conditions: arthritis, chronic obstructive pulmonary disease (COPD), diabetes, ga strointestinal problems, heart-related conditions, and hypertension. D ata on comorbidity were collected by abstracting information from hosp ital medical records. Patients were registered in six geographic areas of the NCI Surveillance, Epidemiology, and End Results (SEER) Program . A satisfied random sample of patients aged 55 to 64, 65 to 74, and 7 5 years or older with the index cancers were selected. Comorbidity dat a were matched with data from the conventional SEER monitoring system. Analyses showed that hypertension is the most prevalent condition and is also much more common as a current management problem rather than as history for the NIA/NCI SEER Study patients. Heart conditions varie d slightly in the percentage of severity reported, but percentages for all rumors remained within a range of 13 to 26% for current and past categories. A similar range was observed for arthritis, with the highe r percentage seen in the current problem category. For episodic compla ints (e.g., gastrointestinal problems), a medical history was more com mon, except for cancers that involve complaints associated with the ma lignancy (e.g., colon and stomach cancers and, to a lesser extent, ova rian cancer). COPD and diabetes were less prevalent. Analyses currentl y under way will determine the impact of a patient's comorbidity burde n on the cancer care continuum of diagnosis, treatment, and survival. The broad and independent effects of chronic conditions, singly and in combination, are being examined. (C) 1996 by Elsevier Science Inc.