Risk Adjusting Survival Outcomes in Hospitals That Treat Patients With Cancer Without Information on Cancer Stage

Purpose Despite advances in the treatment of HIV, HIV-infected people remain at increased risk for many cancers, and the number of non–AIDS-defining cancers is increasing with the aging of the HIV-infected population. No prior study has comprehensively evaluated the effect of HIV on cancer-specific mortality. Patients and Methods We identified cases of 14 common cancers occurring from 1996 to 2010 in six US states participating in a linkage of cancer and HIV/AIDS registries. We used Cox regression to examine the association between patient HIV status and death resulting from the presenting cancer (ascertained from death certificates), adjusting for age, sex, race/ethnicity, year of cancer diagnosis, and cancer stage. We included 1,816,461 patients with cancer, 6,459 (0.36%) of whom were HIV infected. Results Cancer-specific mortality was significantly elevated in HIV-infected compared with HIV-uninfected patients for many cancers: colorectum (adjusted hazard ratio [HR], 1.49; 95% CI, 1.21 to 1.84), pancreas (HR, 1.71; 95% CI, 1.35 to 2.18), larynx (HR, 1.62; 95% CI, 1.06 to 2.47), lung (HR, 1.28; 95% CI, 1.17 to 1.39), melanoma (HR, 1.72; 95% CI, 1.09 to 2.70), breast (HR, 2.61; 95% CI, 2.06 to 3.31), and prostate (HR, 1.57; 95% CI, 1.02 to 2.41). HIV was not associated with increased cancer-specific mortality for anal cancer, Hodgkin lymphoma, or diffuse large B-cell lymphoma. After further adjustment for cancer treatment, HIV remained associated with elevated cancer-specific mortality for common non–AIDS-defining cancers: colorectum (HR, 1.40; 95% CI, 1.09 to 1.80), lung (HR, 1.28; 95% CI, 1.14 to 1.44), melanoma (HR, 1.93; 95% CI, 1.14 to 3.27), and breast (HR, 2.64; 95% CI, 1.86 to 3.73). Conclusion HIV-infected patients with cancer experienced higher cancer-specific mortality than HIV-uninfected patients, independent of cancer stage or receipt of cancer treatment. The elevation in cancer-specific mortality among HIV-infected patients may be attributable to unmeasured stage or treatment differences as well as a direct relationship between immunosuppression and tumor progression.

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Discharge Patterns, Survival Outcomes, and Changes in Clinical Management of Hospitalized Adult Patients with Cancer with a Do-Not-Resuscitate Order

Journal of Palliative Medicine ◽

10.1089/jpm.2013.0554 ◽

2014 ◽

Vol 17 (7) ◽

pp. 776-781 ◽

Cited By ~ 13

Author(s):

Arun A. Azad ◽

Sue-Faye Siow ◽

Ali Tafreshi ◽

Juli Moran ◽

Michael Franco

Keyword(s):

Clinical Management ◽

Adult Patients ◽

Survival Outcomes ◽

Do Not Resuscitate ◽

Patients With Cancer ◽

Discharge Patterns

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The Effect of Natural Disasters on Cancer Care: A Systematic Review

Prehospital and Disaster Medicine ◽

10.1017/s1049023x19001146 ◽

2019 ◽

Vol 34 (s1) ◽

pp. s48-s48

Author(s):

Ralph Xiu-gee Man ◽

David Lack ◽

Charlotte Wyatt ◽

Virginia Murray

Keyword(s):

Systematic Review ◽

Natural Disasters ◽

Health Effects ◽

Cancer Care ◽

Extreme Weather ◽

Extreme Weather Events ◽

Survival Outcomes ◽

Patients With Cancer ◽

Weather Events ◽

Oncology Care

Introduction:As the incidence of cancer and the frequency of extreme weather events rise, disaster mitigation is becoming increasingly relevant to oncology care.Aim:To investigate the effect of natural disasters on cancer care and the associated health effects on patients with cancer through the means of a systematic review.Methods:Between database inception and November 12, 2016, Embase, ScienceDirect, MEDLINE, Scopus, PsycINFO, Web of Science, and CINAHL were searched for articles. Those identifying the effect of natural disasters on oncology services, or the associated health implications for patients with cancer, were included. Only articles published in English were included. Data extraction was done by two authors independently and then verified by all authors. The effects of disaster events on oncology services, survival outcomes, and psychological issues were assessed.Results:Natural disasters cause substantial interruption to the provision of oncology care. Of the 4,593 studies identified, only 85 articles met all the eligibility criteria. Damage to infrastructure, communication systems, medication, and medical record losses substantially disrupt oncology care. The effect of extreme weather events on survival outcomes is limited to only a small number of studies, often with inadequate follow-up periods.Discussion:To the best the authors’ knowledge, this is the first systematic review to assess the existing evidence base on the health effects of natural disaster events on cancer care. Disaster planning must begin to take into consideration patients with cancer.

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Pharmacological Treatment of Depression in Cancer Patients

The British Journal of Psychiatry ◽

10.1192/bjp.169.4.440 ◽

1996 ◽

Vol 169 (4) ◽

pp. 440-443 ◽

Cited By ~ 101

Author(s):

Kees Van Heeringen ◽

Milana Zivkov

Keyword(s):

Cancer Patients ◽

Rating Scale ◽

Controlled Study ◽

Systematic Research ◽

Cancer Stage ◽

Efficacy And Safety ◽

Double Blind ◽

Patients With Cancer ◽

Treatment Of Depression ◽

Hamilton Rating Scale

BackgroundDepression has a reported mean prevalence of 24% in patients diagnosed with cancer. However, little systematic research on the efficacy of antidepressants in patients with cancer has been performed.MethodThe efficacy and safety of mianserin were studied in 55 depressed women with breast cancer (stage I or II and without known metastases), in a randomised, double-blind, six-week, placebo-controlled study.ResultsStatistically significant differences in the decrease in score from baseline on the Hamilton Rating Scale for Depression and the number of responders, favouring mianserin, were present after 28 and 42 days of treatment Significantly more placebo-treated patients prematurely terminated the study due to lack of efficacy while the safety profile of mianserin was similar to that of placebo.ConclusionsTreatment with mianserin resulted in a significant improvement in depressive symptoms in cancer patients, and was well tolerated.

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Association of Obesity With Survival Outcomes in Patients With Cancer

JAMA Network Open ◽

10.1001/jamanetworkopen.2021.3520 ◽

2021 ◽

Vol 4 (3) ◽

pp. e213520

Author(s):

Fausto Petrelli ◽

Alessio Cortellini ◽

Alice Indini ◽

Gianluca Tomasello ◽

Michele Ghidini ◽

...

Keyword(s):

Survival Outcomes ◽

Patients With Cancer

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Cancer Treatment Disparities in HIV-Infected Individuals in the United States

Journal of Clinical Oncology ◽

10.1200/jco.2013.54.8644 ◽

2014 ◽

Vol 32 (22) ◽

pp. 2344-2350 ◽

Cited By ~ 75

Author(s):

Gita Suneja ◽

Meredith S. Shiels ◽

Rory Angulo ◽

Glenn E. Copeland ◽

Lou Gonsalves ◽

...

Keyword(s):

Lung Cancer ◽

Cancer Treatment ◽

Hodgkin’S Lymphoma ◽

Standard Treatment ◽

Survival Rates ◽

Hodgkin's Lymphoma ◽

Cancer Stage ◽

Hiv Status ◽

Patients With Cancer ◽

Hiv And Cancer

Purpose HIV-infected individuals with cancer have worse survival rates compared with their HIV-uninfected counterparts. One explanation may be differing cancer treatment; however, few studies have examined this. Patients and Methods We used HIV and cancer registry data from Connecticut, Michigan, and Texas to study adults diagnosed with non-Hodgkin's lymphoma, Hodgkin's lymphoma, or cervical, lung, anal, prostate, colorectal, or breast cancers from 1996 to 2010. We used logistic regression to examine associations between HIV status and cancer treatment, adjusted for cancer stage and demographic covariates. For a subset of local-stage cancers, we used logistic regression to assess the relationship between HIV status and standard treatment modality. We identified predictors of cancer treatment among individuals with both HIV and cancer. Results We evaluated 3,045 HIV-infected patients with cancer and 1,087,648 patients with cancer without HIV infection. A significantly higher proportion of HIV-infected individuals did not receive cancer treatment for diffuse large B-cell lymphoma (DLBCL; adjusted odds ratio [aOR], 1.67; 95% CI, 1.41 to 1.99), lung cancer (aOR, 2.18; 95% CI, 1.80 to 2.64), Hodgkin's lymphoma (aOR, 1.77; 95% CI, 1.33 to 2.37), prostate cancer (aOR, 1.79; 95% CI, 1.31 to 2.46), and colorectal cancer (aOR, 2.27; 95% CI, 1.38 to 3.72). HIV infection was associated with a lack of standard treatment modality for local-stage DLBCL (aOR, 2.02; 95% CI, 1.50 to 2.72), non–small-cell lung cancer (aOR, 2.43; 95% CI, 1.46 to 4.03), and colon cancer (aOR, 4.77; 95% CI, 1.76 to 12.96). Among HIV-infected individuals, factors independently associated with lack of cancer treatment included low CD4 count, male sex with injection drug use as mode of HIV exposure, age 45 to 64 years, black race, and distant or unknown cancer stage. Conclusion HIV-infected individuals are less likely to receive treatment for some cancers than uninfected people, which may affect survival rates.

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Effects of Serum Albumin, Calcium Levels, Cancer Stage and Performance Status on Weight Loss in Parathyroid Hormone-Related Peptide Positive or Negative Patients with Cancer

Endocrinology and Metabolism ◽

10.3803/enm.2018.33.1.97 ◽

2018 ◽

Vol 33 (1) ◽

pp. 97

Author(s):

Ji-Yeon Lee ◽

Namki Hong ◽

Hye Ryun Kim ◽

Byung Wan Lee ◽

Eun Seok Kang ◽

...

Keyword(s):

Weight Loss ◽

Parathyroid Hormone ◽

Serum Albumin ◽

Performance Status ◽

Cancer Stage ◽

Patients With Cancer ◽

Related Peptide ◽

Parathyroid Hormone Related Peptide ◽

And Performance

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Comparison of All-Cause Mortality Between Canadian Kidney Transplant Recipients and Patients With Cancer: A Population-Based Cohort Study

Canadian Journal of Kidney Health and Disease ◽

10.1177/20543581211056234 ◽

2021 ◽

Vol 8 ◽

pp. 205435812110562

Author(s):

Kyla L. Naylor ◽

S. Joseph Kim ◽

Eric McArthur ◽

Amit X. Garg ◽

Marlee Vinegar ◽

...

Keyword(s):

Prostate Cancer ◽

Cohort Study ◽

Kidney Transplant ◽

Survival Probability ◽

Population Based ◽

Cancer Stage ◽

Transplant Recipients ◽

Kidney Transplant Recipients ◽

Patients With Cancer ◽

Cancer Types

Background: Understanding rates of mortality in kidney transplant recipients relative to other common diseases can enhance our understanding of the mortality burden in kidney transplant recipients. Objective: To compare the survival probability in Canadian female and male kidney transplant recipients with patients with common cancers (female: breast, colorectal, lung, or pancreas; male: prostate, colorectal, lung, or pancreas) in a contemporary population. Design: Population-based cohort study using linked administrative health care databases. Setting: Ontario, Canada. Patients: A total of 6888 incident kidney transplant recipients (median age was 50 and 51 years in females and males, respectively) and a total of 532 452 incident patients with cancer (median age range 60 to 72 years across cancer types) from 1997 to 2015. Measurements: All-cause mortality. Methods: The survival of study participants was described using the Kaplan-Meier product limit estimator. The rate of survival was compared between kidney transplant recipients and patients with cancer using extended Cox regression with a Heaviside function. Results: Kidney transplant recipients had a higher survival probability compared with all cancer types. For example, male kidney transplant recipients had a 5-year survival probability of 89.6% (95% confidence interval [CI]: 88.6%-90.5%) compared with 83.3% (95% CI: 83.1%-83.5%) in patients with prostate cancer, and 14.0% (95% CI: 13.7%-14.3%), 56.1% (95% CI: 55.7%-56.5%), and 9.1% (95% CI: 8.5%-9.7%) in patients with lung, colorectal, and pancreas cancer, respectively. After presenting survival probabilities by age at cohort entry and after adjusting for clinical characteristics, similar results were found with a few exceptions. Unlike the unadjusted analysis, in the adjusted analysis males with prostate cancer had a significantly higher survival compared with kidney transplant recipients and females with breast cancer had higher survival compared with kidney transplant recipients at 2+ years of follow-up. In a subpopulation of the cohort who had information available on cancer stage (ie, stages 1-4), we generally found similar results to our primary analysis with kidney transplant recipients having a higher survival probability compared with each cancer stage. However, female kidney transplant recipients had a lower survival probability compared with females with stage 1 breast cancer, whereas male kidney transplant recipients had a lower survival probability compared with males with stage 1 to 3 prostate cancer. Limitations: External generalizability, residual confounding, and cancer stage could only be provided for a subpopulation. Conclusion: Mortality in kidney transplant recipients is lower than in patients with several cancer types. These results improve our understanding of the mortality burden in this population and reaffirm kidney transplantation as a good treatment option for end-stage kidney disease but also highlight the continuing need to improve posttransplant survival. Trial registration: This is not applicable as this is a population-based cohort study and not a clinical trial.

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