Chronic disease burden among cancer survivors in the California Behavioral Risk Factor Surveillance System, 2009-2010.
OBJECTIVE
The California Behavioral Risk Factor Surveillance System estimates that 56.6 % of cancer survivors report ever being diagnosed with a chronic disease. Few studies have assessed potential variability in comorbidity by cancer type.


METHODS
We used data collected from a representative sample of adult participants in the 2009 and 2010 California Behavioral Risk Factor Surveillance System (n = 18,807). Chronic diseases were examined with cancer survivorship in case/non-case and case/case analyses. Prevalence ratios (PR) and corresponding 95 % confidence intervals (95 % CI) were estimated using Cox proportional hazards models, with adjustment on race, sex, age, education, smoking, and drinking.


RESULTS
Obesity was associated with gynecological cancers (PR 1.74; 95 % CI 1.26-2.41), and being overweight was associated with gynecological (PR 1.40; 95 % CI 1.05-1.86) and urinary (PR 2.19; 95 % CI 1.21-3.95) cancers. Arthritis was associated with infection-related (PR 1.78; 95 % CI 1.12-2.83) and hormone-related (PR 1.20; 95 % CI 1.01-1.42) cancers. Asthma was associated with infection- (PR 2.26; 95 % CI 1.49-3.43), hormone- (PR 1.46; 95 % CI 1.21-1.77), and tobacco- (PR 1.86; 95 % CI 1.25-2.77) related cancers. Chronic obstructive pulmonary disease (COPD) was associated with infection- (PR 2.16; 95 % CI 1.22-3.83) and tobacco-related (PR 2.24; 95 % CI 1.37-3.66) cancers and with gynecological cancers (PR 1.60; 95 % 1.00-2.56).


CONCLUSIONS
This is the first study to examine chronic disease burden among cancer survivors in California. Our findings suggest that the chronic disease burden varies by cancer etiology.


CONCLUSIONS
A clear need has emerged for future biological and epidemiological studies of the interaction between chronic disease and cancer etiology in survivors.
Department of Health and Human Sciences, Affiliate Faculty, The Bioethics Institute, Loyola Marymount University, 1 LMU Drive, MS 8160, Los Angeles, CA, USA, Heather.Tarleton@lmu.edu.
Heather P
HP
Tarleton
Suzanne
S
Ryan-Ibarra
Marta
M
Induni
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001168:Arthritis / Q000191:economics; D001249:Asthma / Q000191:economics; D040343:Behavioral Risk Factor Surveillance System; D015992:Body Mass Index; D002908:Chronic Disease; D017281:Cost of Illness; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000209:etiology / Q000401:mortality*; D009765:Obesity / Q000191:economics; D029424:Pulmonary Disease, Chronic Obstructive / Q000191:economics; D017741:Survivors; D013997:Time Factors