The Comorbidity Checklist: New Strategies Needed for Cancer Care

Meir Rinde
Published: Thursday, Jun 28, 2018
Dr. Hyman Muss from Lineberger Comprehensive Cancer Center
Hyman Muss, MD
Although patients with cancer have high rates of comorbidities that often correlate with poorer outcomes and complicate treatment decisions, hard data are frequently lacking on the interaction between specific regimens and health conditions.

. “And yet we treat them the same way, and then they frequently will have horrendous toxicity because those patients are not included in the trials. We’ve been trying to fix it, but it’s been woefully slow.”

Impact of Comorbidities

Studies have found a wide range of comorbidity rates.2 A large study of patients aged 66 years and older with cancer found that 40% had at least 1 of 15 major comorbid conditions, compared with 32% of people without cancer (Figure).3 Twenty-five percent of the patients with cancer had 1 condition, and 15% had 2 or more. Diabetes was most common at 16.0%, followed by chronic obstructive pulmonary disease (COPD) at 15.5%, congestive heart failure at 9.7%, and cerebrovascular disease at 6.0%. Comorbidity rates were about 53% in patients with lung cancer, 41% with colorectal cancer, 32% with breast cancer, and 31% with prostate cancer.

Figure. A Snapshot of Comorbidities in Individuals ≥66 Years3

Other studies have found greater prevalence of comorbidities. In the study presented at ASCO, 66% of patients with cancer said they had at least 1 comorbidity, led by hypertension at 35%.1 Another study found that 92% of patients had a comorbidity, with an average of 2.7 conditions per person.4 In people both with and without cancer, multiple chronic conditions are more common in older patients, racial minority groups, and patients who are in poverty.5,6
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