 |
 |
|
|
|  PubMed
|
| ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
15 January 1994 | Volume 120 Issue 2 | Pages 104-110
Objective: To determine the effect of comorbidity and stage of disease on 3-year survival in women with primary breast cancer.
Design: Longitudinal, observational study.
Setting: Metropolitan Detroit.
Patients: 936 women ages 40 to 84 years.
Measurements: Data on stage of breast cancer, treatment type, and comorbidity were obtained from Metropolitan Detroit Cancer Surveillance System (MDCSS) files and medical records. Personal interviews were the source of information on social and behavioral factors. Vital status and cause of death were obtained from MDCSS files.
Results: Patients who had 3 or more of 7 selected comorbid conditions had a 20-fold higher rate of mortality from causes other than breast cancer and a 4-fold higher rate of all-cause mortality when compared with patients who had no comorbid conditions. The effects of comorbidity were independent of age, disease stage, tumor size, histologic type, type of treatment, race, and social and behavioral factors. Moreover, women with severe comorbid conditions had uniformly higher mortality rates, and early diagnosis in these women conferred no survival advantage.
Conclusion: Comorbidity in patients with breast cancer appears to be a strong predictor of 3-year survival, independent of the effects of breast cancer stage. This finding suggests that trials assessing the efficacy of screening should routinely include measures of comorbidity.
Author and Article Information
From the University of California at Berkeley, Berkeley, California.
ARTICLE
The Effect of Comorbidity on 3-Year Survival of Women with Primary Breast Cancer
Requests for Reprints: William A. Satariano, PhD, MPH, Epidemiology Program, School of Public Health, University of California at Berkeley, Berkeley, CA 94720.
Grant Support: By a grant from the National Institute on Aging (R01-AG04969), a contract from the National Cancer Institute (N01 CN-55423), and a grant from the American Cancer Society (PBR-67).
CiteULike 
Complore 
Connotea 
Del.icio.us 
Digg 
Facebook 
Reddit 
Technorati 
Twitter What's this?
This article has been cited by other articles:
|
|
 |
|
  T. P. Srokowski, S. Fang, G. N. Hortobagyi, and S. H. Giordano Impact of Diabetes Mellitus on Complications and Outcomes of Adjuvant Chemotherapy in Older Patients With Breast Cancer J. Clin. Oncol., May 1, 2009; 27(13): 2170 - 2176. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. A. Schonberg and E. P. McCarthy Mammography Screening Among Women Age 80 Years and Older: Consider the Risks J. Clin. Oncol., February 1, 2009; 27(4): 640 - 641. [Full Text] [PDF]
|
|
|
|
 |
|
 R. A. Freedman and E. P. Winer Reducing Disparities in Breast Cancer Care--A Daunting but Essential Responsibility J Natl Cancer Inst, December 3, 2008; 100(23): 1661 - 1663. [Full Text] [PDF]
|
|
|
|
 |
|
 M. A. Raji, Y.-F. Kuo, J. L. Freeman, and J. S. Goodwin Effect of a Dementia Diagnosis on Survival of Older Patients After a Diagnosis of Breast, Colon, or Prostate Cancer: Implications for Cancer Care Arch Intern Med, October 13, 2008; 168(18): 2033 - 2040. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 V. Girre, M.-C. Falcou, M. Gisselbrecht, G. Gridel, V. Mosseri, C. Bouleuc, R. Poinsot, L. Vedrine, L. Ollivier, V. Garabige, et al. Does a Geriatric Oncology Consultation Modify the Cancer Treatment Plan for Elderly Patients? J. Gerontol. A Biol. Sci. Med. Sci., July 1, 2008; 63(7): 724 - 730. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
C. J. Bradley, J. P. Clement, and C. Lin Absence of Cancer Diagnosis and Treatment in Elderly Medicaid-Insured Nursing Home Residents J Natl Cancer Inst, January 2, 2008; 100(1): 21 - 31. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. Extermann and A. Hurria Comprehensive Geriatric Assessment for Older Patients With Cancer J. Clin. Oncol., May 10, 2007; 25(14): 1824 - 1831. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
H. B. Muss, L. Biganzoli, D. J. Sargent, and M. Aapro Adjuvant Therapy in the Elderly: Making the Right Decision J. Clin. Oncol., May 10, 2007; 25(14): 1870 - 1875. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
C. Terret, G. B. Zulian, A. Naiem, and G. Albrand Multidisciplinary Approach to the Geriatric Oncology Patient J. Clin. Oncol., May 10, 2007; 25(14): 1876 - 1881. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
D. Crivellari, M. Aapro, R. Leonard, G. von Minckwitz, E. Brain, A. Goldhirsch, A. Veronesi, and H. Muss Breast Cancer in the Elderly J. Clin. Oncol., May 10, 2007; 25(14): 1882 - 1890. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
R. A. Audisio, A. P. Zbar, and M. T. Jaklitsch Surgical Management of Oncogeriatric Patients J. Clin. Oncol., May 10, 2007; 25(14): 1924 - 1929. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. B. Rodin and S. G. Mohile A Practical Approach to Geriatric Assessment in Oncology J. Clin. Oncol., May 10, 2007; 25(14): 1936 - 1944. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M Kleber, M Cybulla, K Bauchmuller, G Ihorst, B Koch, and M Engelhardt Monitoring of renal function in cancer patients: an ongoing challenge for clinical practice Ann. Onc., May 1, 2007; 18(5): 950 - 958. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 A. Sanabria, A. L. Carvalho, J. G. Vartanian, J. Magrin, M. K. Ikeda, and L. P. Kowalski Comorbidity Is a Prognostic Factor in Elderly Patients with Head and Neck Cancer Ann. Surg. Oncol., April 1, 2007; 14(4): 1449 - 1457. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. M. Lichtman, D. Hollis, A. A. Miller, G. L. Rosner, C. A. Rhoades, E. P. Lester, F. Millard, J. Byrd, S. A. Cullinan, D. M. Rosen, et al. Prospective Evaluation of the Relationship of Patient Age and Paclitaxel Clinical Pharmacology: Cancer and Leukemia Group B (CALGB 9762) J. Clin. Oncol., April 20, 2006; 24(12): 1846 - 1851. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 S. Burdette-Radoux and H. B. Muss Adjuvant chemotherapy in the elderly: whom to treat, what regimen? Oncologist, March 1, 2006; 11(3): 234 - 242. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
R. R. Bouknight, C. J. Bradley, and Z. Luo Correlates of Return to Work for Breast Cancer Survivors J. Clin. Oncol., January 20, 2006; 24(3): 345 - 353. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. S. Mandelblatt, W. F. Lawrence, J. Cullen, A. L. Stanton, J. L. Krupnick, L. Kwan, and P. A. Ganz Patterns of Care in Early-Stage Breast Cancer Survivors in the First Year After Cessation of Active Treatment J. Clin. Oncol., January 1, 2006; 24(1): 77 - 84. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
N. L. Keating, M. B. Landrum, E. Guadagnoli, E. P. Winer, and J. Z. Ayanian Factors Related to Underuse of Surveillance Mammography Among Breast Cancer Survivors J. Clin. Oncol., January 1, 2006; 24(1): 85 - 94. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
L. M. Woods, B. Rachet, and M. P. Coleman Origins of socio-economic inequalities in cancer survival: a review Ann. Onc., January 1, 2006; 17(1): 5 - 19. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. M. Geraci, C. P. Escalante, J. L. Freeman, and J. S. Goodwin Comorbid Disease and Cancer: The Need for More Relevant Conceptual Models in Health Services Research J. Clin. Oncol., October 20, 2005; 23(30): 7399 - 7404. [Full Text] [PDF]
|
|
|
|
 |
|
 C. M. Tammemagi, D. Nerenz, C. Neslund-Dudas, C. Feldkamp, and D. Nathanson Comorbidity and Survival Disparities Among Black and White Patients With Breast Cancer JAMA, October 12, 2005; 294(14): 1765 - 1772. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. P. W. Bynum, J. B. Braunstein, P. Sharkey, K. Haddad, and A. W. Wu The Influence of Health Status, Age, and Race on Screening Mammography in Elderly Women Arch Intern Med, October 10, 2005; 165(18): 2083 - 2088. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
P. Maione, F. Perrone, C. Gallo, L. Manzione, F. Piantedosi, S. Barbera, S. Cigolari, F. Rosetti, E. Piazza, S. F. Robbiati, et al. Pretreatment Quality of Life and Functional Status Assessment Significantly Predict Survival of Elderly Patients With Advanced Non--Small-Cell Lung Cancer Receiving Chemotherapy: A Prognostic Analysis of the Multicenter Italian Lung Cancer in the Elderly Study J. Clin. Oncol., October 1, 2005; 23(28): 6865 - 6872. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
T. Wasil and S. M. Lichtman Clinical Pharmacology Issues Relevant to the Dosing and Toxicity of Chemotherapy Drugs in the Elderly Oncologist, September 1, 2005; 10(8): 602 - 612. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 K Miyazaki, N Kikuchi, H Satoh, K Sekizawa, M L G Janssen-Heijnen, and J W W Coebergh Comorbidity in elderly NSCLC patients Thorax, August 1, 2005; 60(8): 704 - 704. [Full Text] [PDF]
|
|
|
|
|
|
L. J. Herrinton, W. E. Barlow, O. Yu, A. M. Geiger, J. G. Elmore, M. B. Barton, E. L. Harris, S. Rolnick, R. Pardee, G. Husson, et al. Efficacy of Prophylactic Mastectomy in Women With Unilateral Breast Cancer: A Cancer Research Network Project J. Clin. Oncol., July 1, 2005; 23(19): 4275 - 4286. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
R. A. Audisio, H. Ramesh, W. E. Longo, A. P. Zbar, and D. Pope Preoperative Assessment of Surgical Risk in Oncogeriatric Patients Oncologist, April 1, 2005; 10(4): 262 - 268. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. G. Elmore, K. Armstrong, C. D. Lehman, and S. W. Fletcher Screening for Breast Cancer JAMA, March 9, 2005; 293(10): 1245 - 1256. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
H. B. Muss, S. Woolf, D. Berry, C. Cirrincione, R. B. Weiss, D. Budman, W. C. Wood, I. C. Henderson, C. Hudis, E. Winer, et al. Adjuvant Chemotherapy in Older and Younger Women With Lymph Node-Positive Breast Cancer JAMA, March 2, 2005; 293(9): 1073 - 1081. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. H. Giordano, G. N. Hortobagyi, S.-W. C. Kau, R. L. Theriault, and M. L. Bondy Breast Cancer Treatment Guidelines in Older Women J. Clin. Oncol., February 1, 2005; 23(4): 783 - 791. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
C. Schairer, P. J. Mink, L. Carroll, and S. S. Devesa Probabilities of Death From Breast Cancer and Other Causes Among Female Breast Cancer Patients J Natl Cancer Inst, September 1, 2004; 96(17): 1311 - 1321. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M L G Janssen-Heijnen, S Smulders, V E P P Lemmens, F W J M Smeenk, H J A A van Geffen, and J W W Coebergh Effect of comorbidity on the treatment and prognosis of elderly patients with non-small cell lung cancer Thorax, July 1, 2004; 59(7): 602 - 607. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
R. T. Penson, K. J. Daniels, and T. J. Lynch Jr. Too Old to Care? Oncologist, June 1, 2004; 9(3): 343 - 352. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. F. Piccirillo, R. M. Tierney, I. Costas, L. Grove, and E. L. Spitznagel Jr Prognostic Importance of Comorbidity in a Hospital-Based Cancer Registry JAMA, May 26, 2004; 291(20): 2441 - 2447. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
D. Crivellari, K. Price, R. D. Gelber, M. Castiglione-Gertsch, C.-M. Rudenstam, J. Lindtner, M. F. Fey, H.-J. Senn, A. S. Coates, J. Collins, et al. Adjuvant Endocrine Therapy Compared With No Systemic Therapy for Elderly Women With Early Breast Cancer: 21-Year Results of International Breast Cancer Study Group Trial IV J. Clin. Oncol., December 15, 2003; 21(24): 4517 - 4523. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 J. Mandelblatt, S. Saha, S. Teutsch, T. Hoerger, A. L. Siu, D. Atkins, J. Klein, M. Helfand, and for the Cost Work Group of the U.S. Preventive Ser The Cost-Effectiveness of Screening Mammography beyond Age 65 Years: A Systematic Review for the U.S. Preventive Services Task Force Ann Intern Med, November 18, 2003; 139(10): 835 - 842. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 K. Monson, D. A. Litvak, and R. J. Bold Surgery in the Aged Population: Surgical Oncology Arch Surg, October 1, 2003; 138(10): 1061 - 1067. [Full Text] [PDF]
|
|
|
|
 |
|
 C. E. Holmes and H. B. Muss Diagnosis and Treatment of Breast Cancer in the Elderly CA Cancer J Clin, July 1, 2003; 53(4): 227 - 244. [Abstract] [Full Text]
|
|
|
|
|
|
R. A. Smith, D. Saslow, K. Andrews Sawyer, W. Burke, M. E. Costanza, W. P. Evans III, R. S. Foster Jr., E. Hendrick, H. J. Eyre, and S. Sener American Cancer Society Guidelines for Breast Cancer Screening: Update 2003 CA Cancer J Clin, May 1, 2003; 53(3): 141 - 169. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
K. W.L. Yee, J. L. Pater, L. Pho, B. Zee, and L. L. Siu Enrollment of Older Patients in Cancer Treatment Trials in Canada: Why is Age a Barrier? J. Clin. Oncol., April 15, 2003; 21(8): 1618 - 1623. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 T. L. Lash, S. S. Thwin, N. J. Horton, E. Guadagnoli, and R. A. Silliman Multiple Informants: A New Method to Assess Breast Cancer Patients' Comorbidity Am. J. Epidemiol., February 1, 2003; 157(3): 249 - 257. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 K. d. C. B. Ribeiro, L. P. Kowalski, and M. d. R. D. d. O. Latorre Perioperative Complications, Comorbidities, and Survival in Oral or Oropharyngeal Cancer Arch Otolaryngol Head Neck Surg, February 1, 2003; 129(2): 219 - 228. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
W. M. Randolph, J. S. Goodwin, J. D. Mahnken, and J. L. Freeman Regular Mammography Use Is Associated with Elimination of Age-Related Disparities in Size and Stage of Breast Cancer at Diagnosis Ann Intern Med, November 19, 2002; 137(10): 783 - 790. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
L. L. Humphrey, M. Helfand, B. K.S. Chan, and S. H. Woolf Breast Cancer Screening: A Summary of the Evidence for the U.S. Preventive Services Task Force Ann Intern Med, September 3, 2002; 137(5_Part_1): 347 - 360. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
P. B. Bach, D. Schrag, O. W. Brawley, A. Galaznik, S. Yakren, and C. B. Begg Survival of Blacks and Whites After a Cancer Diagnosis JAMA, April 24, 2002; 287(16): 2106 - 2113. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
G. N. Hortobagyi Can We Cure Limited Metastatic Breast Cancer? J. Clin. Oncol., February 1, 2002; 20(3): 620 - 623. [Full Text] [PDF]
|
|
|
|
|
|
L. Repetto, L. Fratino, R. A. Audisio, A. Venturino, W. Gianni, M. Vercelli, S. Parodi, D. Dal Lago, F. Gioia, S. Monfardini, et al. Comprehensive Geriatric Assessment Adds Information to Eastern Cooperative Oncology Group Performance Status in Elderly Cancer Patients: An Italian Group for Geriatric Oncology Study J. Clin. Oncol., January 15, 2002; 20(2): 494 - 502. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 H. B. Muss Factors Used to Select Adjuvant Therapy of Breast Cancer in the United States: an Overview of Age, Race, and Socioeconomic Status J Natl Cancer Inst Monographs, December 1, 2001; 2001(30): 52 - 55. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 H. B. Muss Older Age -- Not a Barrier to Cancer Treatment N. Engl. J. Med., October 11, 2001; 345(15): 1128 - 1129. [Full Text] [PDF]
|
|
|
|
|
|
L. C. Walter and K. E. Covinsky Cancer Screening in Elderly Patients: A Framework for Individualized Decision Making JAMA, June 6, 2001; 285(21): 2750 - 2756. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
R. Yancik, M. N. Wesley, L. A. G. Ries, R. J. Havlik, B. K. Edwards, and J. W. Yates Effect of Age and Comorbidity in Postmenopausal Breast Cancer Patients Aged 55 Years and Older JAMA, February 21, 2001; 285(7): 885 - 892. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
R. Yancik, P. A. Ganz, C. G. Varricchio, and B. Conley Perspectives on Comorbidity and Cancer in Older Patients: Approaches to Expand the Knowledge Base J. Clin. Oncol., February 15, 2001; 19(4): 1147 - 1151. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
H. J. Burstein and E. P. Winer Primary Care for Survivors of Breast Cancer N. Engl. J. Med., October 12, 2000; 343(15): 1086 - 1094. [Full Text] [PDF]
|
|
|
|
|
|
P. A.C. Vaeth, W. A. Satariano, and D. R. Ragland Limiting Comorbid Conditions and Breast Cancer Stage at Diagnosis J. Gerontol. A Biol. Sci. Med. Sci., October 1, 2000; 55(10): 593M - 600. [Abstract] [Full Text]
|
|
|
|
|
|
K. d. C. B. Ribeiro, L. P. Kowalski, and M. d. R. D. d. O. Latorre Impact of Comorbidity, Symptoms, and Patients' Characteristics on the Prognosis of Oral Carcinomas Arch Otolaryngol Head Neck Surg, September 1, 2000; 126(9): 1079 - 1085. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
L. Balducci and M. Extermann Management of Cancer in the Older Person: A Practical Approach Oncologist, June 1, 2000; 5(3): 224 - 237. [Abstract] [Full Text]
|
|
|
|
|
|
D. Crivellari, M. Bonetti, M. Castiglione-Gertsch, R. D. Gelber, C.-M. Rudenstam, B. Thurlimann, K. N. Price, A. S. Coates, C. Hurny, J. Bernhard, et al. Burdens and Benefits of Adjuvant Cyclophosphamide, Methotrexate, and Fluorouracil and Tamoxifen for Elderly Patients With Breast Cancer: The International Breast Cancer Study Group Trial VII J. Clin. Oncol., April 7, 2000; 18(7): 1412 - 1422. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. G. Diab, R. M. Elledge, and G. M. Clark Tumor Characteristics and Clinical Outcome of Elderly Women With Breast Cancer J Natl Cancer Inst, April 5, 2000; 92(7): 550 - 556. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. S. Mandelblatt, P. A. Ganz, and K. L. Kahn Proposed Agenda for the Measurement of Quality-of-Care Outcomes in Oncology Practice J. Clin. Oncol., August 1, 1999; 17(8): 2614 - 2614. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 R. M. Merrill, M. L. Brown, A. L. Potosky, G. Riley, S. H. Taplin, W. Barlow, and B. H. Fireman Survival and Treatment for Colorectal Cancer Medicare Patients in Two Group/Staff Health Maintenance Organizations and the Fee-for-Service Setting Med Care Res Rev, June 1, 1999; 56(2): 177 - 196. [Abstract] [PDF]
|
|
|
|
 |
|
 R. ROZENCWAIG, A. VAN NOORT, M. J. MOSKAL, K. L. SMITH, J. A. SIDLES, and F. A. MATSEN III The Correlation of Comorbidity with Function of the Shoulder and Health Status of Patients Who Have Glenohumeral Degenerative Joint Disease J. Bone Joint Surg. Am., August 1, 1998; 80(8): 1146 - 53. [Abstract] [Full Text]
|
|
|
|
|
|
F. A. Pugliano, J. F. Piccirillo, M. R. Zequeira, B. Emami, C. A. Perez, J. R. Simpson, and J. M. Fredrickson Clinical-Severity Staging System for Oropharyngeal Cancer: Five-Year Survival Rates Arch Otolaryngol Head Neck Surg, October 1, 1997; 123(10): 1118 - 1124. [Abstract] [PDF]
|
|
|
|
|
|
C. J. Newschaffer, L. Penberthy, C. E. Desch, S. M. Retchin, and M. Whittemore The Effect of Age and Comorbidity in the Treatment of Elderly Women With Nonmetastatic Breast Cancer Arch Intern Med, January 8, 1996; 156(1): 85 - 90. [Abstract] [PDF]
|
|
