Top

Published in:

Open Access 01-06-2018

Health status of older cancer survivors—results of the PolSenior study

Authors: Joanna Sulicka, Agnieszka Pac, Monika Puzianowska-Kuźnicka, Tomasz Zdrojewski, Jerzy Chudek, Beata Tobiasz-Adamczyk, Małgorzata Mossakowska, Anna Skalska, Andrzej Więcek, Tomasz Grodzicki

Published in: Journal of Cancer Survivorship | Issue 3/2018

Abstract

Purpose

The purpose of this study is to characterize health status of older cancer survivors using data from the population-based PolSenior study.

Methods

We compared cancer survivors and non-cancer subjects according to comorbidities, functional status, mental health, and sociodemographic factors.

Results

There were 286 (5.8%) cancer survivors in a population of 4943 adults aged 65 years and older. The mean age of cancer survivors was 79.4 ± 8.2 years and the median time since cancer diagnosis was 8.5 years (Q1–Q3: 4–16 years). After adjustment for age, sex, education, marital status, and number of comorbidities, compared with a non-cancer population, cancer survivors were more likely to experience falls (OR = 1.38; 95% CI: 1.04–1.83), and to report poor health (OR = 1.49; 95%CI: 1.83–2.06), but cancer survivorship was not associated with impairments in instrumental activities of daily living (IADLs). Age and university education, but neither the time from cancer diagnosis nor the number of comorbidities, were associated with impairments in cancer survivors. Three or more chronic diseases were found in over 50% of cancer survivors and in 38% of the non-cancer population (p < 0.001).

Conclusions

Cancer survivors over the age of 65 years have a higher prevalence of falls, are more likely to report poor health status, and have a higher number of chronic conditions than the non-cancer population, but they maintain independence in IADLs. Advanced age and elementary education are associated with increased occurrence of functional impairments in older cancer survivors

Implications for cancer survivors

Older cancer survivors may require preventive services to reduce the risk of functional decline.

Vrdoljak E, Wojtukiewicz MZ, Pienkowski T, Bodoky G, Berzinec P, Finek J, et al. Cancer epidemiology in central, south and eastern European countries. Croat Med J. 2011;52(4):478–87. https://doi.org/10.3325/cmj.2011.52.478.CrossRefPubMedPubMedCentral

Capocaccia R, Colonna M, Corazziari I, De Angelis R, Francisci S, Micheli A, et al. Measuring cancer prevalence in Europe: the EUROPREVAL project. Ann Oncol. 2002;13(6):831–9. https://doi.org/10.1093/annonc/mdf152.CrossRefPubMed

Hewitt M, Rowland JH, Yancik R. Cancer survivors in the United States: age, health, and disability. J Gerontol A Biol Sci Med Sci. 2003;58(1):82–91.CrossRefPubMed

Holmes HM, Nguyen HT, Nayak P, Oh JH, Escalante CP, Elting LS. Chronic conditions and health status in older cancer survivors. Eur J Int Med. 2014;25(4):374–8. https://doi.org/10.1016/j.ejim.2013.12.003.CrossRef

Bledowski P, Mossakowska M, Chudek J, Grodzicki T, Milewicz A, Szybalska A, et al. Medical, psychological and socioeconomic aspects of aging in Poland. Assumptions and objectives of the PolSenior project. Exp Gerontol. 2011;46(12):1003–9. https://doi.org/10.1016/j.exger.2011.09.006.CrossRefPubMed

Spoelstra SL, Given BA, Schutte DL, Sikorskii A, You M, Given CW. Do older adults with cancer fall more often? A comparative analysis of falls in those with and without cancer. Oncol Nurs Forum. 2013;40(2):E69–78. https://doi.org/10.1188/13.ONF.E69-E78.CrossRefPubMed

Winters-Stone KM, Moe E, Graff JN, Dieckmann NF, Stoyles S, Borsch C, et al. Falls and frailty in prostate cancer survivors: current, past, and never users of androgen deprivation therapy. J Am Geriatr Soc. 2017;65(7):1414–9. https://doi.org/10.1111/jgs.14795.CrossRefPubMedPubMedCentral

Mohile SG, Fan L, Reeve E, Jean-Pierre P, Mustian K, Peppone L, et al. Association of cancer with geriatric syndromes in older Medicare beneficiaries. J Clin Oncol. 2011;29(11):1458–64. https://doi.org/10.1200/JCO.2010.31.6695.CrossRefPubMedPubMedCentral

Ward PR, Wong MD, Moore R, Naeim A. Fall-related injuries in elderly cancer patients treated with neurotoxic chemotherapy: a retrospective cohort study. J Geriatr Oncol. 2014;5(1):57–64. https://doi.org/10.1016/j.jgo.2013.10.002.CrossRefPubMed

10.

Gironés R, Torregrosa D, Díaz-Beveridge R. Comorbidity, disability and geriatric syndromes in elderly breast cancer survivors. Results of a single-center experience. Crit Rev Oncol Hematol. 2010;73(3):236–45. https://doi.org/10.1016/j.critrevonc.2009.08.002.CrossRefPubMed

11.

Mohile SG, Xian Y, Dale W, Fisher SG, Rodin M, Morrow GR, et al. Association of a cancer diagnosis with vulnerability and frailty in older Medicare beneficiaries. J Natl Cancer Inst. 2009;101(17):1206–15. https://doi.org/10.1093/jnci/djp239.CrossRefPubMedPubMedCentral

12.

Stafford RS, Cyr PL. The impact of cancer on the physical function of the elderly and their utilization of health care. Cancer. 1997;80(10):1973–80. https://doi.org/10.1002/(SICI)1097-0142(19971115)80:10%3C1973::AID-CNCR15%3E3.0.CO;2-V.

13.

Piotrowicz K, Pac A, Skalska AB, Chudek J, Klich-Rączka A, Szybalska A, et al. Clustering of geriatric deficits emerges to be an essential feature of ageing - results of a cross-sectional study in Poland. Aging. 2016;8(10):2437–48. https://doi.org/10.18632/aging.101055.CrossRefPubMed

14.

Garman KS, Pieper CF, Seo P, Cohen HJ. Function in elderly cancer survivors depends on comorbidities. J Gerontol A Biol Sci Med Sci. 2003;58(12):M1119–24. https://doi.org/10.1093/gerona/58.12.M1119.CrossRefPubMed

15.

van der Heide I, Wang J, Droomers M, Spreeuwenberg P, Rademakers J, Uiters E. The relationship between health, education, and health literacy: results from the dutch adult literacy and life skills S\survey. J Health Commun. 2013;18(sup1):172–84. https://doi.org/10.1080/10810730.2013.825668.CrossRefPubMedPubMedCentral

16.

Leach CR, Bellizzi KM, Hurria A, Reeve BB. Is it my cancer or am I just getting older?: impact of cancer on age-related health conditions of older cancer survivors. Cancer. 2016;122(12):1946–53. https://doi.org/10.1002/cncr.29914.CrossRefPubMed

17.

Musicco M, Adorni F, Di Santo S, Prinelli F, Pettenati C, Caltagirone C, et al. Inverse occurrence of cancer and Alzheimer disease: a population-based incidence study. Neurology. 2013;81(4):322–8. https://doi.org/10.1212/WNL.0b013e31829c5ec1.CrossRefPubMed

18.

Zhang Q, Guo S, Zhang X, Tang S, Shao W, Han X, et al. Inverse relationship between cancer and Alzheimer's disease: a systemic review meta-analysis. Neurol Sci. 2015;36(11):1987–94. https://doi.org/10.1007/s10072-015-2282-2.CrossRefPubMed

19.

Driver JA, Beiser A, Au R, Kreger BE, Splansky GL, Kurth T, et al. Inverse association between cancer and Alzheimer's disease: results from the Framingham heart study. BMJ. 2012;344(mar12 1):e1442. https://doi.org/10.1136/bmj.e1442.CrossRefPubMedPubMedCentral

20.

Heflin LH, Meyerowitz BE, Hall P, Lichtenstein P, Johansson B, Pedersen NL, et al. Cancer as a risk factor for long-term cognitive deficits and dementia. J Natl Cancer Inst. 2005;97(11):854–6. https://doi.org/10.1093/jnci/dji137.CrossRefPubMed

21.

Hovaldt HB, Suppli NP, Olsen MH, Steding-Jessen M, Hansen DG, Moller H, et al. Who are cancer survivors? A nationwide study in Denmark, 1943–2010. Br J Cancer. 2015;112(9):1549–53. https://doi.org/10.1038/bjc.2015.68.CrossRefPubMedPubMedCentral

22.

Armstrong GT, Liu Q, Yasui Y, Neglia JP, Leisenring W, Robison LL, et al. Late mortality among 5-year survivors of childhood cancer: a summary from the childhood cancer survivor study. J Clin Oncol. 2009;27(14):2328–38. https://doi.org/10.1200/JCO.2008.21.1425.CrossRefPubMedPubMedCentral

23.

Sulicka J, Surdacki A, Mikołajczyk T, Strach M, Gryglewska B, Ćwiklińska M, et al. Elevated markers of inflammation and endothelial activation and increased counts of intermediate monocytes in adult survivors of childhood acute lymphoblastic leukemia. Immunobiology. 2013;218(5):810–6. https://doi.org/10.1016/j.imbio.2012.09.003.CrossRefPubMed

24.

Seo PH, Pieper CF, Cohen HJ. Effects of cancer history and comorbid conditions on mortality and healthcare use among older cancer survivors. Cancer. 2004;101(10):2276–84. https://doi.org/10.1002/cncr.20606.CrossRefPubMed

25.

Lassemillante AC, Doi SA, Hooper JD, Prins JB, Wright OR. Prevalence of osteoporosis in prostate cancer survivors II: a meta-analysis of men not on androgen deprivation therapy. Endocrine. 2015;50(2):344–54. https://doi.org/10.1007/s12020-015-0536-7.CrossRefPubMed

26.

Morgans AK, Fan KH, Koyama T, Albertsen PC, Goodman M, Hamilton AS, et al. Influence of age on incident diabetes and cardiovascular disease in prostate cancer survivors receiving androgen deprivation therapy. J Urol. 2015;193(4):1226–31. https://doi.org/10.1016/j.juro.2014.11.006.CrossRefPubMed

27.

Nead KT, Gaskin G, Chester C, Swisher-McClure S, Leeper N, Shah NH. Association between androgen deprivation therapy and risk of dementia. JAMA Oncol. 2017;3(1):49–55. https://doi.org/10.1001/jamaoncol.2016.3662.CrossRefPubMed

28.

Prajsner A, Chudek J, Szybalska A, Piotrowicz K, Zejda J, Więcek A. Socioeconomic determinants of prostate-specific antigen testing and estimation of the prevalence of undiagnosed prostate cancer in an elderly polish population based on the PolSenior study. Arch Med Sci. 2016;12(5):1028–35. https://doi.org/10.5114/aoms.2015.55271.CrossRefPubMedPubMedCentral

29.

Pandya C, Magnuson A, Dale W, Lowenstein L, Fung C, Mohile SG. Association of falls with health-related quality of life (HRQOL) in older cancer survivors: a population based study. J Geriatr Oncol. 2016;7(3):201–10. https://doi.org/10.1016/j.jgo.2016.01.007.CrossRefPubMedPubMedCentral

30.

Weaver KE, Forsythe LP, Reeve BB, Alfano CM, Rodriguez JL, Sabatino SA, et al. Mental and physical health–related quality of life among US cancer survivors: population estimates from the 2010 National Health Interview Survey. Cancer Epidemiol Biomark Prev. 2012;21(11):2108–17. https://doi.org/10.1158/1055-9965.EPI-12-0740.CrossRef

Title: Health status of older cancer survivors—results of the PolSenior study
Authors: Joanna Sulicka
Agnieszka Pac
Monika Puzianowska-Kuźnicka
Tomasz Zdrojewski
Jerzy Chudek
Beata Tobiasz-Adamczyk
Małgorzata Mossakowska
Anna Skalska
Andrzej Więcek
Tomasz Grodzicki
Publication date: 01-06-2018
Publisher: Springer US
Published in: Journal of Cancer Survivorship / Issue 3/2018
Print ISSN: 1932-2259
Electronic ISSN: 1932-2267
DOI: https://doi.org/10.1007/s11764-017-0672-6

Webinar | 19-02-2024 | 17:30 (CET)

Keynote webinar | Spotlight on antibody–drug conjugates in cancer

Watch now

Antibody–drug conjugates (ADCs) are novel agents that have shown promise across multiple tumor types. Explore the current landscape of ADCs in breast and lung cancer with our experts, and gain insights into the mechanism of action, key clinical trials data, existing challenges, and future directions.

Dr. Véronique Diéras

Prof. Fabrice Barlesi

Developed by: Springer Medicine

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusions

Implications for cancer survivors

Please log in to get access to this content

Other articles of this Issue 3/2018

The continuum of breast cancer care and outcomes in the U.S. Military Health System: an analysis by benefit type and care source

Cardiovascular disease incidence in adolescent and young adult cancer survivors: a retrospective cohort study

Predictors of vasomotor symptoms among breast cancer survivors

Fatigue and depressive symptoms improve but remain negatively related to work functioning over 18 months after return to work in cancer patients

Evolution of neurocognitive function in long-term survivors of childhood acute lymphoblastic leukemia treated with chemotherapy only

Survivorship care plan outcomes for primary care physicians, cancer survivors, and systems: a scoping review

Keynote webinar | Spotlight on antibody–drug conjugates in cancer