title: The impact of comorbidity on cancer and its treatment.
abstract: Answer questions and earn CME/CNE Comorbidity is common among cancer patients and, with an aging population, is becoming more so. Comorbidity potentially affects the development, stage at diagnosis, treatment, and outcomes of people with cancer. Despite the intimate relationship between comorbidity and cancer, there is limited consensus on how to record, interpret, or manage comorbidity in the context of cancer, with the result that patients who have comorbidity are less likely to receive treatment with curative intent. Evidence in this area is lacking because of the frequent exclusion of patients with comorbidity from randomized controlled trials. There is evidence that some patients with comorbidity have potentially curative treatment unnecessarily modified, compromising optimal care. Patients with comorbidity have poorer survival, poorer quality of life, and higher health care costs. Strategies to address these issues include improving the evidence base for patients with comorbidity, further development of clinical tools to assist decision making, improved integration and coordination of care, and skill development for clinicians. CA Cancer J Clin 2016;66:337-350. © 2016 American Cancer Society.
authors.affiliation: Director, Cancer Control and Screening Research Group, University of Otago, Wellington, New Zealand.
authors.forename: Diana
authors.initials: D
authors.lastname: Sarfati
authors.affiliation: Senior Staff Specialist, Flinders Center for Innovation in Cancer, Flinders University, Adelaide, South Australia, Australia.
authors.forename: Bogda
authors.initials: B
authors.lastname: Koczwara
authors.affiliation: Senior Lecturer in Medicine, Department of Medicine, Dunedin School of Medicine, University of Otago, Wellington, New Zealand.|Consultant Medical Oncologist, Southern District Health Board, Dunedin, New Zealand.
authors.forename: Christopher
authors.initials: C
authors.lastname: Jackson
mesh_terms: D000375:Aging; D000570:American Cancer Society; D015897:Comorbidity; D004509:Education, Nursing, Continuing; D006801:Humans; D009369:Neoplasms / Q000191:economics / Q000453:epidemiology / Q000451:nursing* / Q000628:therapy; D015995:Prevalence; D011788:Quality of Life; D012307:Risk Factors; D015996:Survival Rate; D014481:United States / Q000453:epidemiology
keywords: cancer; chronic disease; comorbidity; multimorbidity; neoplasms