Geographical Variation in Underlying Social Deprivation, Cardiovascular and Other Comorbidities in Patients with Potentially Curable Cancers in England: Results from a National Registry Dataset Analysis.

Autor: Waterhouse JV; Breast Unit, Department of Medicine, The Royal Marsden NHS Foundation Trust, SM2 5PT, London, United Kingdom; Breast Cancer Research Division, The Institute of Cancer Research, London, United Kingdom., Welch CA; Biostatistics Research Group, Department of Health Sciences, University of Leicester, University Road, LE1 7RH, Leicester, United Kingdom; National Disease Registration Service, NHS England, 10 South Colonnade, Canary Wharf, E14 4PU, London, United Kingdom., Battisti NML; Breast Unit, Department of Medicine, The Royal Marsden NHS Foundation Trust, SM2 5PT, London, United Kingdom; Breast Cancer Research Division, The Institute of Cancer Research, London, United Kingdom., Sweeting MJ; Biostatistics Research Group, Department of Health Sciences, University of Leicester, University Road, LE1 7RH, Leicester, United Kingdom; Statistical Innovation, Oncology Biometrics, Oncology R&D, AstraZeneca, Cambridge, United Kingdom., Paley L; National Disease Registration Service, NHS England, 10 South Colonnade, Canary Wharf, E14 4PU, London, United Kingdom., Lambert PC; Biostatistics Research Group, Department of Health Sciences, University of Leicester, University Road, LE1 7RH, Leicester, United Kingdom; Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden., Deanfield J; Institute of Cardiovascular Sciences, University College London, 62 Huntley St London, WC1E 6DD, United Kingdom., de Belder M; National Institute for Cardiovascular Outcomes Research, NHS Arden & Greater East Midlands Commissioning Support Unit, 2nd floor 1 St Martin's le Grand London, EC1A 4AS, United Kingdom., Peake MD; Department of Health Sciences, University of Leicester, University Rd, Leicester, LE1 7RH, United Kingdom; University Hospitals of Leicester NHS Trust, Leicester, United Kingdom., Adlam D; University Hospitals of Leicester NHS Trust, Leicester, United Kingdom; Department of Cardiovascular Sciences and NIHR Leicester Biomedical Research Centre, University of Leicester, Glenfield Hospital, Groby Road, Leicester, LE3 9QP, United Kingdom. Electronic address: da134@leicester.ac.uk., Ring A; Breast Unit, Department of Medicine, The Royal Marsden NHS Foundation Trust, SM2 5PT, London, United Kingdom; Breast Cancer Research Division, The Institute of Cancer Research, London, United Kingdom.
Jazyk: angličtina
Zdroj: Clinical oncology (Royal College of Radiologists (Great Britain)) [Clin Oncol (R Coll Radiol)] 2023 Dec; Vol. 35 (12), pp. e708-e719. Date of Electronic Publication: 2023 Sep 01.
DOI: 10.1016/j.clon.2023.08.009
Abstrakt: Aims: To describe the prevalence of cardiovascular disease (CVD), multiple comorbidities and social deprivation in patients with a potentially curable cancer in 20 English Cancer Alliances.
Materials and Methods: This National Registry Dataset Analysis used national cancer registry data and CVD databases to describe rates of CVD, comorbidities and social deprivation in patients diagnosed with a potentially curable malignancy (stage I-III breast cancer, stage I-III colon cancer, stage I-III rectal cancer, stage I-III prostate cancer, stage I-IIIA non-small cell lung cancer, stage I-IV diffuse large B-cell lymphoma, stage I-IV Hodgkin lymphoma) between 2013 and 2018. Outcome measures included observation of CVD prevalence, other comorbidities (evaluated by the Charlson Comorbidity Index) and deprivation (using the Index of Multiple Deprivation) according to tumour site and allocation to Cancer Alliance. Patients were allocated to CVD prevalence tertiles (minimum: <33.3rd percentile; middle: 33.3rd to 66.6th percentile; maximum: >66.6th percentile).
Results: In total, 634 240 patients with a potentially curable malignancy were eligible. The total CVD prevalence for all cancer sites varied between 13.4% (CVD n = 2058; 95% confidence interval 12.8, 13.9) and 19.6% (CVD n = 7818; 95% confidence interval 19.2, 20.0) between Cancer Alliances. CVD prevalence showed regional variation both for male (16-26%) and female patients (8-16%) towards higher CVD prevalence in northern Cancer Alliances. Similar variation was observed for social deprivation, with the proportion of cancer patients being identified as most deprived varying between 3.3% and 32.2%, depending on Cancer Alliance. The variation between Cancer Alliance for total comorbidities was much smaller.
Conclusion: Social deprivation, CVD and other comorbidities in patients with a potentially curable malignancy in England show significant regional variations, which may partly contribute to differences observed in treatments and outcomes.
(Copyright © 2023 The Authors. Published by Elsevier Ltd.. All rights reserved.)
Databáze: MEDLINE
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