The impact of preexisting comorbidities on receipt of cancer therapy among women with Stage I-III breast cancer in the Detroit Research on Cancer Survivors cohort.

Autor: Raychaudhuri S; Department of Medical Oncology/Hematology, University of Pittsburgh, Hillman Cancer Center, Pittsburgh, Pennsylvania, USA., Kyko JM; Department of Oncology, Karmanos Cancer Institute at Wayne State University, Detroit, Michigan, USA., Ruterbusch JJ; Department of Oncology, Karmanos Cancer Institute at Wayne State University, Detroit, Michigan, USA., Pandolfi SS; Department of Oncology, Karmanos Cancer Institute at Wayne State University, Detroit, Michigan, USA., Beebe-Dimmer JL; Department of Oncology, Karmanos Cancer Institute at Wayne State University, Detroit, Michigan, USA.; Population Studies and Disparities Research Program, Karmanos Cancer Institute, Detroit, Michigan, USA., Schwartz AG; Department of Oncology, Karmanos Cancer Institute at Wayne State University, Detroit, Michigan, USA.; Population Studies and Disparities Research Program, Karmanos Cancer Institute, Detroit, Michigan, USA., Simon MS; Department of Oncology, Karmanos Cancer Institute at Wayne State University, Detroit, Michigan, USA.; Population Studies and Disparities Research Program, Karmanos Cancer Institute, Detroit, Michigan, USA.
Jazyk: angličtina
Zdroj: Cancer medicine [Cancer Med] 2023 Sep; Vol. 12 (18), pp. 19021-19032. Date of Electronic Publication: 2023 Aug 11.
DOI: 10.1002/cam4.6456
Abstrakt: Purpose: Pre-existing comorbidities play an important role in choice of cancer treatment. We retrospectively evaluated the relationship between pre-existing comorbidities and receipt of local and systemic therapy in a cohort of Black women with Stage I-III breast cancer.
Methods: The study population for analysis included 1169 women with Stage I-III disease enrolled in the Detroit Research on Cancer Survivors (ROCS) cohort. Information on comorbidities, socio-demographic, and clinical variables were obtained from self-reported questionnaires and the cancer registry. Comorbidities were analyzed individually, and comorbidity burden was categorized as low (0-1), moderate (2-3) or high (≥4). We used logistic regression analysis to evaluate factors associated with receipt of local treatment (surgery ± radiation; N = 1156), hormonal (N = 848), and chemotherapy (N = 680). Adjusted models included variables selected a priori that were significant predictors in univariate analysis.
Results: Receipt of treatment was categorized into local (82.6%), hormonal (73.7%), and/or chemotherapy (79.9%). Prior history of arthritis and depression were both associated with a lower likelihood to receive local treatment, [odds ratio (OR), 95% confidence interval (CI), 0.66, 0.47-0.93, and 0.53, 0.36-0.78], respectively. Obesity was associated with higher likelihood of receiving hormonal therapy (OR: 1.64, 95% CI: 1.19, 2.26), and heart failure a lower likelihood (OR: 0.46, 95% CI: 0.23, 0.90). Older age (P trend  <0.01) and increasing co-morbidity burden (P trend  = 0.02) were associated with lower likelihood of receiving chemotherapy.
Conclusion: History of prior co-morbidities has a potentially detrimental influence on receipt of recommended cancer-directed treatment among women with Stage I-III breast cancer.
(© 2023 The Authors. Cancer Medicine published by John Wiley & Sons Ltd.)
Databáze: MEDLINE
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