Cancer survivors with multiple chronic conditions: A rising challenge—Trend analysis from National Health Interview Survey.

2020 ◽  
Vol 38 (15_suppl) ◽  
pp. e24089-e24089
Author(s):  
Changchuan Jiang ◽  
Haowei Wang ◽  
Qian Wang ◽  
Binbin Zheng ◽  
Charles L. Shapiro
Keyword(s):  
Public Health ◽  
Risk Factors ◽  
Cancer Survivors ◽  
Chronic Conditions ◽  
National Health Interview Survey ◽  
Heart Diseases ◽  
Multiple Chronic Conditions ◽  
History Of ◽  
Interview Survey ◽  
History Of Cancer

e24089 Background: Cancer survivors are disproportionally influenced by chronic/comorbid diseases, which were linked to more psychological distress, increased healthcare service use, higher medical costs, adverse clinical outcomes, and financial hardship in cancer survivors. However, the trend in chronic diseases remains unknown among cancer survivors. Methods: We conducted a population-based study using serial samples of the National Health Interview Survey (NHIS) from 2002 through 2018. The outcomes include hypertension, diabetes, stroke, coronary artery disease (angina pectoris, coronary heart disease, heart attack), other heart diseases, COPD (emphysema, chronic bronchitis in the past 12 month), hepatitis, arthritis, morbid obesity (BMI > 40 or BMI > 35 with obesity-related diseases), asthma attack within 12 months, weak/failing kidney, any liver disease. We included adults who 1) have a history of cancer for except non-melanoma skin cancer; 2) report outcomes of diseases. Multiple chronic conditions(MCC) were defined as three or more non-cancer chronic conditions. Multivariable logistics regression was used to estimate the annual percent change(APC) in prevalence from 2002 to 2018, using SAS 9.4 and accounting for the design of NHIS. Results: 30728 adult cancer survivors and 485233 adults without a history of cancer were included in the final analysis. We found increasing prevalence in hypertension, diabetes, kidney disease, liver diseases and morbid obesity from 2002 to 2018, and decreasing prevalence in heart diseases, COPD, and hepatitis. The prevalence of MCC increased significantly in cancer survivors from 23.6% in 2002 to 29.6% in 2018 (APC 0.9%, p trend < 0.01). This was especially evident in younger patients aged 18 to 44 (APC 4.4%, p trend < 0.01) and African-American patients (APC 2.2%, p trend = 0.01). Conclusions: Our findings suggest that comorbid illnesses, especially MCC, have become an emerging public health burden for cancer survivors, which requires attention and more effective risk factors interventions. Future studies are needed to identify a better strategy to modify risk factors and prevent long term comorbidities for cancer survivors. It is also important to call for public health planning given severe chronic diseases burden for this rapid-growing but vulnerable community.

scholarly journals Economic Burden of Chronic Conditions Among Survivors of Cancer in the United States

2017 ◽  
Vol 35 (18) ◽  
pp. 2053-2061 ◽  
Author(s):  
Gery P. Guy ◽  
K. Robin Yabroff ◽  
Donatus U. Ekwueme ◽  
Sun Hee Rim ◽  
Rui Li ◽  
...  
Keyword(s):  
Heart Disease ◽  
Economic Burden ◽  
Chronic Conditions ◽  
The United States ◽  
Medical Expenditures ◽  
Medical Expenditure ◽  
Multiple Chronic Conditions ◽  
Lost Productivity ◽  
History Of ◽  
History Of Cancer

Purpose The prevalence of cancer survivorship and chronic health conditions is increasing. Limited information exists on the economic burden of chronic conditions among survivors of cancer. This study examines the prevalence and economic effect of chronic conditions among survivors of cancer. Methods Using the 2008 to 2013 Medical Expenditure Panel Survey, we present nationally representative estimates of the prevalence of chronic conditions (heart disease, high blood pressure, stroke, emphysema, high cholesterol, diabetes, arthritis, and asthma) and multiple chronic conditions (MCCs) and the incremental annual health care use, medical expenditures, and lost productivity for survivors of cancer attributed to individual chronic conditions and MCCs. Incremental use, expenditures, and lost productivity were evaluated with multivariable regression. Results Survivors of cancer were more likely to have chronic conditions and MCCs compared with adults without a history of cancer. The presence of chronic conditions among survivors of cancer was associated with substantially higher annual medical expenditures, especially for heart disease ($4,595; 95% CI, $3,262 to $5,927) and stroke ($3,843; 95% CI, $1,983 to $5,704). The presence of four or more chronic conditions was associated with increased annual expenditures of $10,280 (95% CI, $7,435 to $13,125) per survivor of cancer. Annual lost productivity was higher among survivors of cancer with other chronic conditions, especially stroke ($4,325; 95% CI, $2,687 to $5,964), and arthritis ($3,534; 95% CI, $2,475 to $4,593). Having four or more chronic conditions was associated with increased annual lost productivity of $9,099 (95% CI, $7,224 to $10,973) per survivor of cancer. The economic impact of chronic conditions was similar among survivors of cancer and individuals without a history of cancer. Conclusion These results highlight the importance of ensuring access to lifelong personalized screening, surveillance, and chronic disease management to help manage chronic conditions, reduce disruptions in employment, and reduce medical expenditures among survivors of cancer.

Gender disparity on cigarette smoking among cancer survivors: Results from the National Health Interview Survey.

2020 ◽  
Vol 38 (15_suppl) ◽  
pp. e24040-e24040
Author(s):  
Changchuan Jiang ◽  
Haowei Wang ◽  
Lei Deng ◽  
Qian Wang ◽  
Xuesong Han ◽  
...  
Keyword(s):  
Smoking Cessation ◽  
Cancer Survivors ◽  
Smoking Prevalence ◽  
Smoking Rate ◽  
Current Smoking ◽  
Female Survivors ◽  
History Of ◽  
Interview Survey ◽  
Female Cancer Survivors ◽  
History Of Cancer

e24040 Background: The smoking rate has been declining in the United States. Smoking cessation is a critical part of cancer survivorship care. Males have higher smoking rate than females in the general population. However, it remains unclear if cancer status modified the effect of gender on smoking rates. Methods: To evaluate the long-term pattern of smoking prevalence among female cancer survivors, we used the National Health Interview Survey 2000-2017 to estimate the age-adjusted current smoking rates among cancer survivors and participants without a history of cancer for men and women separately. Multivariable linear regression was used to estimate age-adjusted smoking rate in each group, using the US 2010 Census as the standardization population. We also used multivariable logistic regression to examine the whether cancer history modified the influence of gender on current smoking rate. All statistical analyses were performed with SAS 9.4 and accounted for NHIS survey design. Results: Of 526,547 participants, we identified 32,091 cancer survivors, including 11,642 male and 20,449 female cancer survivors. Male cancer survivors had a slightly lower smoking rates than non-cancer male participants (cancer survivors: 16.2%-29.7% vs non-cancer participants: 16.8%-24.4%; OR = 0.94, 95%CI 0.88-1.00, p = 0.05) after adjusting age and year of survey. However, female cancer survivors had a significant higher prevalence of smoking compared with non-cancer female participants (cancer survivors: 20.1-32.6% vs non-cancer participants: women: 12.8%-20.4%; OR = 1.45, 95%CI 1.38-1.52, p < 0.001) during the same period. The gaps in smoking prevalence between female cancer survivors and male cancer survivors were more significant than the gaps between male non-cancer participants and female non-cancer participants from 2000 to 2017 (p interaction < 0.001). Conclusions: Although more men smoke among people without a history of cancer, female survivors had a higher age-adjusted smoking rate than their male counterparts. Effective smoking cessation interventions need to target female survivors as well as male survivors. A gender-sensitive approach is required to address their specific needs in smoking cessation. [Table: see text]

scholarly journals MULTIPLE CHRONIC CONDITIONS IN OLDER CANCER SURVIVORS WITH AND WITHOUT HIV

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S317-S317
Author(s):  
Siran Koroukian ◽  
Nicholas Schiltz ◽  
Johnie Rose ◽  
Gregory Cooper ◽  
Cynthia Owusu ◽  
...  
Keyword(s):  
Cancer Survivors ◽  
Chronic Conditions ◽  
Medicare Beneficiary ◽  
Descriptive Analysis ◽  
Multiple Chronic Conditions ◽  
Critical Gap ◽  
Persons Living With Hiv ◽  
Comorbidity Burden ◽  
History Of ◽  
Hiv And Cancer

Abstract Background: With more effective treatment for both HIV and cancer, longevity among persons living with HIV (PLwHIV) has improved significantly. However, little is known about whether the comorbidity profile of cancer survivors differs between PLwHIV and their HIV-free counterparts. To address this critical gap in knowledge, we compared the occurrence and combination of multiple chronic conditions (MCCs) among older cancer survivors by HIV status. Methods: We used national data from the 2014 Chronic Conditions Data Warehouse (CCW) as part of the Medicare Beneficiary Summary File, which flags 66 conditions, including HIV/AIDS, and history of common cancers (colorectal, lung, prostate, and leukemias/lymphomas). We limited our study population to men age 65 years or older who were cancer survivors. In addition to descriptive analysis, we conducted association rule mining (ARM) analysis to compare the prevalence of the most common MCCs among cancer survivors, with and without HIV. Results: We identified 1.3 million individuals, of which 1,901 (0.15%) were PLwHIV. Compared to their HIV-free counterparts, PLwHIV were younger (mean of 72.5 and 77.0 years); more were non-White (41.8% vs. 13.5%); and more of them presented with anemia (44.8% vs. 35.3%), chronic kidney disease (CKD, 41.9% vs. 26.6%), depression (26.6% vs. 13.9%), viral hepatitis (20.4% vs. 0.70%), and/or liver disease (10.7% vs. 4.8%; p &lt; 0.001 for all comparisons). ARM results showed a prominence of CKD in the most common top 5 combinations of conditions. Conclusion: Despite being younger than their HIV-free counterparts, PLwHIV with history of cancer carry a significantly greater comorbidity burden.

scholarly journals Use of Medications for Treating Anxiety and Depression in Cancer Survivors in the United States

2017 ◽  
Vol 35 (1) ◽  
pp. 78-85 ◽  
Author(s):  
Nikki A. Hawkins ◽  
Ashwini Soman ◽  
Natasha Buchanan Lunsford ◽  
Steven Leadbetter ◽  
Juan L. Rodriguez
Keyword(s):  
United States ◽  
Cancer Survivors ◽  
Medication Use ◽  
The United States ◽  
Population Based ◽  
Anxiety And Depression ◽  
Current Medication ◽  
History Of ◽  
Interview Survey ◽  
History Of Cancer

Purpose This study used population-based data to estimate the percentage of cancer survivors in the United States reporting current medication use for anxiety and depression and to characterize the survivors taking this type of medication. Rates of medication use in cancer survivors were compared with rates in the general population. Methods We analyzed data from the National Health Interview Survey, years 2010 to 2013, identifying cancer survivors (n = 3,184) and adults with no history of cancer (n = 44,997) who completed both the Sample Adult Core Questionnaire and the Adult Functioning and Disability Supplement. Results Compared with adults with no history of cancer, cancer survivors were significantly more likely to report taking medication for anxiety (16.8% v 8.6%, P < .001), depression (14.1% v 7.8%, P < .001), and one or both of these conditions combined (19.1% v 10.4%, P < .001), indicating that an estimated 2.5 million cancer survivors were taking medication for anxiety or depression in the United States at that time. Survivor characteristics associated with higher rates of medication use for anxiety included being younger than 65 years old, female, and non-Hispanic white, and having public insurance, a usual source of medical care, and multiple chronic health conditions. Survivor characteristics associated with medication use for depression were largely consistent with those for anxiety, with the exceptions that insurance status was not significant, whereas being widowed/divorced/separated was associated with more use. Conclusion Cancer survivors in the United States reported medication use for anxiety and depression at rates nearly two times those reported by the general public, likely a reflection of greater emotional and physical burdens from cancer or its treatment.

scholarly journals Comparison of modifiable health behaviours between persons with and without cancer: the Multiethnic Cohort

2011 ◽  
Vol 14 (10) ◽  
pp. 1796-1804 ◽  
Author(s):  
Nicholas J Ollberding ◽  
Gertraud Maskarinec ◽  
Lynne R Wilkens ◽  
Brian E Henderson ◽  
Laurence N Kolonel
Keyword(s):  
Risk Factors ◽  
Cancer Research ◽  
Cancer Survivors ◽  
Health Behaviours ◽  
Modifiable Risk Factors ◽  
Dietary Recommendations ◽  
Multiethnic Cohort ◽  
Adult Cancer Survivors ◽  
History Of ◽  
History Of Cancer

AbstractObjectiveTo compare the prevalence of modifiable risk factors for cancer and other chronic diseases between adult cancer survivors and persons with no history of cancer.DesignCross-sectional.SettingPopulation-based sample residing in California and Hawaii.SubjectsA total of 177 003 men and women aged 45–75 years who participated in the Multiethnic Cohort Study (MEC). Logistic regression was used to examine adherence to recommendations regarding modifiable risk factors among cancer survivors (n 16 346) when compared with cohort members with no history of cancer (n 160 657).ResultsCancer survivors were less likely than cohort members with no history of cancer to meet recommendations specified in the World Cancer Research Fund/American Institute for Cancer Research (WCRF/AICR) 2007 report (OR = 0·97; 95 % CI 0·96, 0·99). No difference between groups was seen for adherence to dietary recommendations alone (OR = 0·99; 95 % CI 0·98, 1·01). Site-specific analyses showed that results for colorectal cancer were similar to those for all cancers combined, but survivors of breast (OR = 1·04; 95 % CI 1·02, 1·07) and prostate (OR = 1·04; 95 % CI 1·01, 1·07) cancer were more likely to meet dietary recommendations. Latino survivors were less likely to adhere to WCRF/AICR recommendations than Latino controls; however, differences across ethnic groups were not significant (Pinteraction = 0·64).ConclusionsThe modest differences found between adult cancer survivors and persons with no history of cancer suggest that a diagnosis of cancer in itself may not be associated with improvements in health behaviours related to cancer and other chronic diseases.

scholarly journals Hypogonadism in Children with a Previous History of Cancer: Endocrine Management and Follow-Up

2019 ◽  
Vol 91 (2) ◽  
pp. 93-103 ◽  
Author(s):  
Hanneke M. van Santen ◽  
Marry M. van den Heuvel-Eibrink ◽  
Marianne D. van de Wetering ◽  
W. Hamish Wallace
Keyword(s):  
Risk Factors ◽  
Cancer Survivors ◽  
Childhood Cancer ◽  
Previous History ◽  
Childhood Cancer Survivors ◽  
History Of ◽  
Primary Gonadal Failure ◽  
History Of Cancer ◽  
Gonadal Failure

Hypogonadism after treatment for childhood cancer is a recognized complication and its cause may be subdivided into primary gonadal failure and central hypogonadism. Here, we provide an overview of the risk factors for the development of hypogonadism, assessment and potential interventions and give a summary of the current recommendations for management and follow-up of hypogonadism in childhood cancer survivors.

Sign in / Sign up

Export Citation Format

Share Document