title: Comorbidities in lung cancer: prevalence, severity and links with socioeconomic status and treatment.
abstract: BACKGROUND
  Survival from lung cancer remains poor in Scotland, UK. Although the presence of comorbidities is known to influence outcomes, detailed quantification of comorbidities is not available in routinely collected audit or cancer registry data. The aim of the present study was to assess the prevalence and severity of comorbidities in patients with newly diagnosed lung cancer across four centres throughout Scotland using validated criteria.
  
  
  METHODS
  Between 2005 and 2008, all patients with newly diagnosed lung cancer coming through the multidisciplinary teams in four Scottish centres were included in the study. Patient demographics, WHO/Eastern Cooperative Oncology Group performance status, clinicopathological features and primary treatment modality were recorded.
  
  
  RESULTS
  Details of 882 patients were collected prospectively. The majority of patients (87.3%) had at least one comorbidity, the most common being weight loss (53%), chronic obstructive pulmonary disease (43%), renal impairment (28%) and ischaemic heart disease (27%). A composite score was produced that included both number and severity of comorbidities. One in seven patients (15.3%) had severe comorbidity scores. There were statistically significant variations in comorbidity scores between treatment centres and between non-small cell lung carcinoma treatment groups. Disease stage was not associated with comorbidity score.
  
  
  CONCLUSIONS
  There is a high prevalence of multiple, severe comorbidities in Scottish patients with lung cancer, and these vary by site and treatment group. Further research is needed to determine the relationship between comorbidity scores and survival in these patients.
authors.affiliation: Department of Clinical Oncology, Beatson Oncology Centre, Glasgow, UK.
authors.forename: Derek
authors.initials: D
authors.lastname: Grose
authors.affiliation: Department Public Health, University of Glasgow, Glasgow, UK.
authors.forename: David S
authors.initials: DS
authors.lastname: Morrison
authors.affiliation: Department of Child Health, University of Aberdeen, Aberdeen, UK.
authors.forename: Graham
authors.initials: G
authors.lastname: Devereux
authors.affiliation: Department of Clinical Oncology, Beatson Oncology Centre, Glasgow, UK.
authors.forename: Richard
authors.initials: R
authors.lastname: Jones
authors.affiliation: Department of Respiratory Medicine, Inverclyde Royal Hospital, Inverclyde, UK.
authors.forename: Dave
authors.initials: D
authors.lastname: Sharma
authors.affiliation: Department of Respiratory Medicine, Queen Margaret Hospital, Dunfermline, UK.
authors.forename: Colin
authors.initials: C
authors.lastname: Selby
authors.affiliation: Department of Respiratory Medicine, Inverclyde Royal Hospital, Inverclyde, UK.
authors.forename: Kirsty
authors.initials: K
authors.lastname: Docherty
authors.affiliation: Department of Clinical Oncology, Beatson Oncology Centre, Glasgow, UK.
authors.forename: David
authors.initials: D
authors.lastname: McIntosh
authors.affiliation: Department of Internal Medicine, Wishaw General Hospital, Wishaw, UK.
authors.forename: Greig
authors.initials: G
authors.lastname: Louden
authors.affiliation: Department of Oncology, Aberdeen Royal Infirmary, Aberdeen, UK.
authors.forename: Marianne
authors.initials: M
authors.lastname: Nicolson
authors.affiliation: Department of Surgery, University of Glasgow, Glasgow, UK.
authors.forename: Donald C
authors.initials: DC
authors.lastname: McMillan
authors.affiliation: Glasgow Royal Infirmary, Glasgow, UK.
authors.forename: Robert
authors.initials: R
authors.lastname: Milroy
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002289:Carcinoma, Non-Small-Cell Lung / Q000453:epidemiology* / Q000503:physiopathology; D015897:Comorbidity; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000453:epidemiology* / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D017202:Myocardial Ischemia / Q000453:epidemiology*; D020380:Needs Assessment; D015995:Prevalence; D011379:Prognosis; D011446:Prospective Studies; D029424:Pulmonary Disease, Chronic Obstructive / Q000453:epidemiology*; D051436:Renal Insufficiency, Chronic / Q000453:epidemiology*; D012606:Scotland / Q000453:epidemiology; D012720:Severity of Illness Index; D012923:Social Class; D016019:Survival Analysis; D015431:Weight Loss
keywords: comorbidity; epidemiology;  Lung cancer