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Published in: BMC Cancer 1/2021

Open Access 01-12-2021 | Research article

Prevalence of multimorbidity in adults with cancer, and associated health service utilization in Ontario, Canada: a population-based retrospective cohort study

Authors: Anna Péfoyo Koné, Deborah Scharf

Published in: BMC Cancer | Issue 1/2021

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Abstract

Background

The majority of people with cancer have at least one other chronic health condition. With each additional chronic disease, the complexity of their care increases, as does the potential for negative outcomes including premature death. In this paper, we describe cancer patients’ clinical complexity (i.e., multimorbidity; MMB) in order to inform strategic efforts to improve care and outcomes for people with cancer of all types and commonly occurring chronic diseases.

Methods

We conducted a population-based, retrospective cohort study of adults diagnosed with cancer between 2003 and 2013 (N = 601,331) identified in Ontario, Canada healthcare administrative data. During a five to 15-year follow-up period (through March 2018), we identified up to 16 co-occurring conditions and patient outcomes for the cohort, including health service utilization and death.

Results

MMB was extremely common, affecting more than 91% of people with cancer. Nearly one quarter (23%) of the population had five or more co-occurring conditions. While we saw no differences in MMB between sexes, MMB prevalence and level increased with age. MMB prevalence and type of co-occurring conditions also varied by cancer type. Overall, MMB was associated with higher rates of health service utilization and mortality, regardless of other patient characteristics, and specific conditions differentially impacted these rates.

Conclusions

People with cancer are likely to have at least one other chronic medical condition and the presence of MMB negatively affects health service utilization and risk of premature death. These findings can help motivate and inform health system advances to improve care quality and outcomes for people with cancer and MMB.
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Literature
5.
go back to reference St John PD, Tyas SL, Menec V, Tate R. Multimorbidity, disability, and mortality in community-dwelling older adults. Canadian Family Physician Medecin De Famille Canadien. 2014;60(5):e272–80.PubMedPubMedCentral St John PD, Tyas SL, Menec V, Tate R. Multimorbidity, disability, and mortality in community-dwelling older adults. Canadian Family Physician Medecin De Famille Canadien. 2014;60(5):e272–80.PubMedPubMedCentral
6.
go back to reference Salako O, Okediji PT, Habeebu MY, Fatiregun OA, Awofeso OM, Okunade KS, et al. The pattern of comorbidities in cancer patients in Lagos, South-Western Nigeria. Ecancermedicalscience. 2018;12:843.CrossRef Salako O, Okediji PT, Habeebu MY, Fatiregun OA, Awofeso OM, Okunade KS, et al. The pattern of comorbidities in cancer patients in Lagos, South-Western Nigeria. Ecancermedicalscience. 2018;12:843.CrossRef
8.
go back to reference Ng HS, Roder D, Vitry A. Prevalence of Comorbidities and Health Status among Current Cancer and Cancer Survivors: An Australian Population-Based Study.: Value in Health; 2016. Ng HS, Roder D, Vitry A. Prevalence of Comorbidities and Health Status among Current Cancer and Cancer Survivors: An Australian Population-Based Study.: Value in Health; 2016.
17.
go back to reference Dima S, Chen KH, Wang KJ, Wang KM, Teng NC. Effect of comorbidity on lung Cancer diagnosis timing and mortality: a Nationwide population-based cohort study in Taiwan. Biomed Res Int. 2018;2018:1252897.CrossRef Dima S, Chen KH, Wang KJ, Wang KM, Teng NC. Effect of comorbidity on lung Cancer diagnosis timing and mortality: a Nationwide population-based cohort study in Taiwan. Biomed Res Int. 2018;2018:1252897.CrossRef
37.
go back to reference Diederichs C, Berger K, Bartels DB. The measurement of multiple chronic diseases--a systematic review on existing multimorbidity indices. J Gerontol A Biol Sci Med Sci. 2011;66(3):301–11.CrossRef Diederichs C, Berger K, Bartels DB. The measurement of multiple chronic diseases--a systematic review on existing multimorbidity indices. J Gerontol A Biol Sci Med Sci. 2011;66(3):301–11.CrossRef
41.
go back to reference Koné PA, Mondor L, Maxwell C, Kabir US, Rosella L, Wodchis WP. Rising burden of multimorbidity and related socio-demographic factors: a repeated cross-sectional study of Ontarians. Canadian Journal of Public Health. 2021 (accepted). Koné PA, Mondor L, Maxwell C, Kabir US, Rosella L, Wodchis WP. Rising burden of multimorbidity and related socio-demographic factors: a repeated cross-sectional study of Ontarians. Canadian Journal of Public Health. 2021 (accepted).
49.
go back to reference Gruneir A, Griffith LE, Fisher K, Perez R, Favotto L, Patterson C, et al. Measuring multimorbidity series. An overlooked complexity - comparison of self-report vs. administrative data in community-living adults: paper 3. Agreement across data sources and implications for estimating associations with health service use. J Clin Epidemiol. 2020;124:173–82. https://doi.org/10.1016/j.jclinepi.2020.04.018.CrossRefPubMed Gruneir A, Griffith LE, Fisher K, Perez R, Favotto L, Patterson C, et al. Measuring multimorbidity series. An overlooked complexity - comparison of self-report vs. administrative data in community-living adults: paper 3. Agreement across data sources and implications for estimating associations with health service use. J Clin Epidemiol. 2020;124:173–82. https://​doi.​org/​10.​1016/​j.​jclinepi.​2020.​04.​018.CrossRefPubMed
51.
go back to reference Davis KA, Sudlow CL, Hotopf M. Can mental health diagnoses in administrative data be used for research? A systematic review of the accuracy of routinely collected diagnoses. BMC Psychiatry. 2016;16:263.CrossRef Davis KA, Sudlow CL, Hotopf M. Can mental health diagnoses in administrative data be used for research? A systematic review of the accuracy of routinely collected diagnoses. BMC Psychiatry. 2016;16:263.CrossRef
Metadata
Title
Prevalence of multimorbidity in adults with cancer, and associated health service utilization in Ontario, Canada: a population-based retrospective cohort study
Authors
Anna Péfoyo Koné
Deborah Scharf
Publication date
01-12-2021
Publisher
BioMed Central
Published in
BMC Cancer / Issue 1/2021
Electronic ISSN: 1471-2407
DOI
https://doi.org/10.1186/s12885-021-08102-1

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