Does comorbidity interact with colorectal cancer to increase mortality? A nationwide population-based cohort study

R. Erichsen, E. Horváth-Puhó, L. H Iversen, T. L. Lash, H. T. Sørensen

Research output: Contribution to journalArticle

35 Citations (Scopus)

Abstract

Background:It is unknown whether comorbidity interacts with colorectal cancer (CRC) to increase the rate of mortality beyond that explained by the independent effects of CRC and comorbid conditions.Methods:We conducted a cohort study (1995-2010) of all Danish CRC patients (n=56 963), and five times as many persons from the general population (n=271 670) matched by age, gender, and specific comorbidities. To analyse comorbidity, we used the Charlson Comorbidity Index (CCI) scores. We estimated standardised mortality rates per 1000 person-years, and calculated interaction contrasts as a measure of the excess mortality rate not explained by the independent effects of CRC or comorbidities.Results:Among CRC patients with a CCI score=1, the 0-1 year mortality rate was 415 out of 1000 person-years (95% confidence interval (CI): 401, 430) and the interaction accounted for 9.3% of this rate (interaction contrast=39 out of 1000 person-years, 95% CI: 22, 55). For patients with a CCI score of 4 or more, the interaction accounted for 34% of the mortality (interaction contrast=262 out of 1000 person-years, 95% CI: 215, 310). The interaction between CRC and comorbidities had limited influence on mortality beyond 1 year after diagnosis.Conclusion:Successful treatment of the comorbidity is pivotal and may reduce the mortality attributable to comorbidity itself, and also the mortality attributable to the interaction.

Original languageEnglish
Pages (from-to)2005-2013
Number of pages9
JournalBritish journal of cancer
Volume109
Issue number7
DOIs
Publication statusPublished - Oct 1 2013

Keywords

  • biological interaction
  • colorectal neoplasm
  • epidemiology
  • survival
  • synergy

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

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