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Chronic diseases among older cancer patients.

Deckx, L.D., Akker, M.A. van der, Metsemakers, J.M., Knottnerus, A.K., Schellevis, F.G., Buntinx, F.B. Chronic diseases among older cancer patients.: , 2011. 38 p. Abstract. The Cancer and Primary Care Research International Network (Ca-PRI) 4th international Annual Meeting 'New pathways in cancer care: Substitution from Secondary to Primary Care?', 26-27 mei 2011, Noordwijkerhout. In: Abstractbook Ca-PRI 2011. Noordwijkerhout: The Cancer and Primary Care Research International Network, 2011.
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Introduction: With the growing number of older cancer patients, the burden of chronic diseases among older cancer patients will become increasingly important. Chronic diseases often interfere with treatment decisions and prognosis for cancer patients. However, little is known about the occurrence of chronic diseases among older cancer patients. Aim: We aim to examine the frequency of pre-existing and subsequent chronic diseases among cancer patients above age 60 in comparison with non-cancer patients. Methods: This study was carried out within the context of the Registration Network Family Practices, which is a computerized continuous primary care database in Maastricht (the Netherlands). Data were available from 2.846 cancer patients and 5.820 age- and sex- matched non-cancer patients aged 60 years and older. All non-cancer patients were assigned a reference date; the date of cancer diagnosis of their matched case. The burden of chronic diseases was assessed in two ways: 1) the lifetime prevalence of chronic diseases at the time of cancer diagnosis or reference date; 2) the incidence of new chronic diseases, diagnosed within a period of 5 years after the diagnosis of cancer or reference date. Cancer patients and non-cancer patients were compared using the Mantel-Haenszel test for pre-existing and total burden of chronic diseases (cross-sectional) and univariate cox regression analyses for subsequent chronic diseases (longitudinally). All analyses were stratified by age (60 - 64 years and ≥ 75 years) and sex. Results: Although pre-existing COPD and myocardial infarction and subsequent venous thrombosis and lung embolism were significantly more frequent (p < 0.05) among older cancer patients than among older non-cancer patients, the occurrence of the most common pre-existing and subsequent chronic diseases was largely similar in both groups. Conclusion: Only a small number of diseases was more frequent in cancer patients compared to non-cancer patients. However, the burden is expected to be significantly higher in the group of older cancer patients, because of the burden already caused by the cancer. There is a need to develop new guidelines and policies for patients with a combination of cancer and one or more other chronic diseases.