Interaction between comorbidity and cancer.
BACKGROUND
Older patients have an average of three comorbidities in addition to their cancer. Oncologic studies have usually ignored this aspect when adjusting for confounders. There is mounting evidence that comorbidity interacts with risk, survival, disease progression, and treatment of elderly patients with cancer. The strength of many of these interactions increases with age.


METHODS
A review of the literature was undertaken regarding two of these interactions: cancer risk and prognosis.


RESULTS
In older patients, the risk and behavior of cancer can be strongly affected by comorbidities and their related treatment. Rather than a blanket effect, this effect might be attached to groups of syndromes with common pathophysiologic mechanisms. This is notably true for metabolic disorders and inflammatory diseases.


CONCLUSIONS
In addition to focusing on the influence of cancer treatment on comorbidity or on the effect of comorbidity in delivering cancer treatment, future endeavors will need to consider the direct impact of comorbidity on the risk and the behavior of the cancer in elderly patients.
Extermann
Martine
M
Senior Adult Oncology Program, H. Lee Moffitt Cancer Center & Research Institute, Tampa, FL 33612, USA. extermann@moffitt.org
D015897:Comorbidity; D006801:Humans; D009369:Neoplasms / Q000150:complications / Q000401:mortality*; D015996:Survival Rate