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Comorbidity trajectories in working age cancer survivors: A national study of Swedish men
Örebro University, School of Medical Sciences. (Clinical Epidemiology and Biostatistics)ORCID iD: 0000-0002-2088-0530
Örebro University, School of Medical Sciences. Örebro University Hospital. Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden. (Clinical Epidemiology and Biostatistics)ORCID iD: 0000-0002-3649-2639
Örebro University, School of Medical Sciences. Örebro University Hospital. (Clinical Epidemiology and Biostatistics)
Örebro University, School of Medical Sciences. Örebro University Hospital. Clinical Epidemiology Unit, Department of Medicine, Karolinska Institutet, Stockholm, Sweden; Department of Epidemiology and Public Health, University College London, London, United Kingdom. (Clinical Epidemiology and Biostatistics)ORCID iD: 0000-0001-6328-5494
2017 (English)In: Cancer Epidemiology, ISSN 1877-7821, E-ISSN 1877-783X, Vol. 48, p. 48-55, article id S1877-7821(17)30039-5Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: A large proportion of cancer survivors are of working age, and maintaining health is of interest both for their working and private life. However, patterns and determinants of comorbidity over time among adult cancer survivors are incompletely described. We aimed to identify distinct comorbidity trajectories and their potential determinants.

METHODS: In a cohort study of Swedish men born between 1952 and 1956, men diagnosed with cancer between 2000 and 2003 (n=878) were matched with cancer-free men (n=4340) and followed over five years after their first year of survival. Comorbid diseases were identified using hospital diagnoses and included in the analysis using group-based trajectory modelling. The association of socioeconomic and developmental characteristics were assessed using multinomial logit models.

RESULTS: Four distinct comorbidity trajectories were identified. As many as 84% of cancer survivors remained at very low levels of comorbidity, and the distribution of trajectories was similar among the cancer survivors and the cancer-free men. Increases in comorbidity were seen among those who had comorbid disease at baseline and among those with poor summary disease scores in adolescence. Socioeconomic characteristics and physical, cognitive and psychological function were associated with types of trajectory in unadjusted models but did not retain independent relationships with them after simultaneous adjustment.

CONCLUSIONS: Among working-age male cancer survivors, the majority remained free or had very low levels of comorbidity. Those with poorer health in adolescence and pre-existing comorbid diseases at cancer diagnosis may, however, benefit from follow-up to prevent further increases in comorbidity.

Place, publisher, year, edition, pages
Elsevier, 2017. Vol. 48, p. 48-55, article id S1877-7821(17)30039-5
Keywords [en]
Adolescence, Cancer, Comorbidity, Longitudinal, Risk factor, Survivor, Trajectory
National Category
Cancer and Oncology
Research subject
Oncology
Identifiers
URN: urn:nbn:se:oru:diva-57346DOI: 10.1016/j.canep.2017.03.001ISI: 000405151500008PubMedID: 28365446Scopus ID: 2-s2.0-85016519311OAI: oai:DiVA.org:oru-57346DiVA, id: diva2:1098811
Funder
Forte, Swedish Research Council for Health, Working Life and Welfare, 2014-2128
Note

Funding Agencies:

UK Economic and Social Research Council (ESRC)  RES-596-28-0001  ES/J019119/1 

Available from: 2017-05-26 Created: 2017-05-26 Last updated: 2018-07-20Bibliographically approved

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