title: Influence of comorbidity on cancer patients' rehabilitation needs, participation in rehabilitation activities and unmet needs: a population-based cohort study.
abstract: OBJECTIVE
  This study aims to investigate possible associations between cancer survivors' comorbidity status and their (1) need for rehabilitation, (2) participation in rehabilitation activities and (3) unmet needs for rehabilitation in a 14-month period following date of diagnosis.
  
  
  METHODS
  We performed a population-based cohort study including incident cancer patients diagnosed from 1 October 2007 to 30 September 2008 in two regions in Denmark. Fourteen months after diagnosis, participants completed a questionnaire measuring different aspects and dimensions of rehabilitation. Individual information on comorbidity was based on hospital contacts from 1994 and until diagnosis, subsequently classified according to the Charlson comorbidity index. Logistic regression analyses were used to explore the association between comorbidity and outcomes for rehabilitation. Analyses were conducted overall and stratified for gender, age and cancer type.
  
  
  RESULTS
  A total of 3,439 patients responded (70%). Comorbidity at all levels was statistically significant associated with a physical rehabilitation need, and moderate to severe comorbidity was statistically significant associated with a need in the emotional, family-oriented and financial areas as well as participation in physical-related rehabilitation activities. Stratified analyses showed that significant results in most cases were related to being older than 65 years or having colorectal or prostate cancer.
  
  
  CONCLUSIONS
  Comorbidity at all levels was significantly associated with needs for physical rehabilitation. Moderate to severe comorbidity was further associated with other areas of need and participation in physical area activities. This should be taken into account when planning rehabilitation interventions for cancer survivors. Differences among subgroups could help target interventions and should be explored further.
authors.affiliation: Research Centre for Cancer Rehabilitation, Research Unit of General Practice, University of Southern Denmark, JB Winsløws Vej 9A, 5000, Odense C, Denmark, lholm@health.sdu.dk.
authors.forename: Lise Vilstrup
authors.initials: LV
authors.lastname: Holm
authors.forename: Dorte Gilså
authors.initials: DG
authors.lastname: Hansen
authors.forename: Jakob
authors.initials: J
authors.lastname: Kragstrup
authors.forename: Christoffer
authors.initials: C
authors.lastname: Johansen
authors.forename: Rene dePont
authors.initials: Rd
authors.lastname: Christensen
authors.forename: Peter
authors.initials: P
authors.lastname: Vedsted
authors.forename: Jens
authors.initials: J
authors.lastname: Søndergaard
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D015897:Comorbidity; D003718:Denmark / Q000453:epidemiology; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000175:diagnosis / Q000453:epidemiology* / Q000523:psychology / Q000534:rehabilitation*; D011795:Surveys and Questionnaires; D017741:Survivors / Q000523:psychology / Q000706:statistics & numerical data; D055815:Young Adult