title: Increasing prevalence of comorbidity in patients with colorectal cancer in the South of the Netherlands 1995-2010.
abstract: Comorbidity has large impact on colorectal cancer (CRC) treatment and outcomes and may increase as the population ages. We aimed to evaluate the prevalence and time trends of comorbid diseases in patients with CRC from 1995 to 2010. The Eindhoven Cancer Registry registers comorbidity in all patients with primary CRC in the South of the Netherlands. We analyzed the prevalence of serious comorbid diseases in four time frames from 1995 to 2010. Thereby, we addressed its association with age, gender and socio-economic status (SES). The prevalence of comorbidity was registered in 27,339 patients with primary CRC. During the study period, the prevalence of comorbidity increased from 47% to 62%, multimorbidity increased from 20% to 37%. Hypertension and cardiovascular diseases were most prevalent and increased largely over time (respectively 16-29% and 12-24%). Pulmonary diseases increased in women, but remained stable in men. Average age at diagnosis increased from 68.3 to 69.5 years (p = 0.004). A low SES and male gender were associated with a higher risk of comorbidity (not changing over time). This study indicates that comorbidity among patients with CRC is common, especially in males and patients with a low SES. The prevalence of comorbidity increased from 1995 to 2010, in particular in presumably nutritional diseases. Ageing, increased life expectancy and life style changes may contribute to more comorbid diseases. Also, improved awareness among health care providers on the importance of comorbidity may have resulted in better registration. The increasing burden of comorbidity in patients with CRC emphasizes the need for more focus on individualized medicine.
authors.affiliation: Department of Surgery, Leiden University Medical Centre, Leiden, The Netherlands. n.j.van_leersum@lumc.nl
authors.forename: N J
authors.initials: NJ
authors.lastname: van Leersum
authors.forename: M L G
authors.initials: ML
authors.lastname: Janssen-Heijnen
authors.forename: M W J M
authors.initials: MW
authors.lastname: Wouters
authors.forename: H J T
authors.initials: HJ
authors.lastname: Rutten
authors.forename: J W
authors.initials: JW
authors.lastname: Coebergh
authors.forename: R A E M
authors.initials: RA
authors.lastname: Tollenaar
authors.forename: V E P P
authors.initials: VE
authors.lastname: Lemmens
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002318:Cardiovascular Diseases / Q000453:epidemiology* / Q000209:etiology; D002648:Child; D015331:Cohort Studies; D015179:Colorectal Neoplasms / Q000150:complications / Q000453:epidemiology*; D015897:Comorbidity; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006973:Hypertension / Q000453:epidemiology* / Q000209:etiology; D008171:Lung Diseases / Q000453:epidemiology* / Q000209:etiology; D008297:Male; D008875:Middle Aged; D009426:Netherlands / Q000453:epidemiology; D015995:Prevalence; D011379:Prognosis; D012042:Registries; D013997:Time Factors; D055815:Young Adult