TY - JOUR

T1 - Impact of multimorbidity and polypharmacy on mortality after cancer

T2 - a nationwide registry-based cohort study in Denmark 2005–2017

AU - Thomsen, Mette K.

AU - Løppenthin, Katrine B.

AU - Bidstrup, Pernille E.

AU - Andersen, Elisabeth W.

AU - Dalton, Susanne

AU - Petersen, Lone N.

AU - Pappot, Helle

AU - Mortensen, Christiane E.

AU - Christensen, Mikkel B.

AU - Frølich, Anne

AU - Lassen, Ulrik

AU - Johansen, Christoffer

N1 - Publisher Copyright: © 2023 Acta Oncologica Foundation.

PY - 2023

Y1 - 2023

N2 - Background: Concurrent chronic diseases and treatment hereof in patients with cancer may increase mortality. In this population-based study we examined the individual and combined impact of multimorbidity and polypharmacy on mortality, across 20 cancers and with 13-years follow-up in Denmark. Materials and Methods: This nationwide study included all Danish residents with a first primary cancer diagnosed between 1 January 2005 and 31 December 2015, and followed until the end of 2017. We defined multimorbidity as having one or more of 20 chronic conditions in addition to cancer, registered in the five years preceding diagnosis, and polypharmacy as five or more redeemed medications 2–12 months prior to cancer diagnosis. Cox regression analyses were used to estimate the effects of multimorbidity and polypharmacy, as well as the combined effect on mortality. Results: A total of 261,745 cancer patients were included. We found that patients diagnosed with breast, prostate, colon, rectal, oropharynx, bladder, uterine and cervical cancer, malignant melanoma, Non-Hodgkin lymphoma, and leukemia had higher mortality when the cancer diagnosis was accompanied by multimorbidity and polypharmacy, while in patients with cancer of the lung, esophagus, stomach, liver, pancreas, kidney, ovarian and brain & central nervous system, these factors had less impact on mortality. Conclusion: We found that multimorbidity and polypharmacy was associated with higher mortality in patients diagnosed with cancer types that typically have a favorable prognosis compared with patients without multimorbidity and polypharmacy. Multimorbidity and polypharmacy had less impact on mortality in cancers that typically have a poor prognosis.

AB - Background: Concurrent chronic diseases and treatment hereof in patients with cancer may increase mortality. In this population-based study we examined the individual and combined impact of multimorbidity and polypharmacy on mortality, across 20 cancers and with 13-years follow-up in Denmark. Materials and Methods: This nationwide study included all Danish residents with a first primary cancer diagnosed between 1 January 2005 and 31 December 2015, and followed until the end of 2017. We defined multimorbidity as having one or more of 20 chronic conditions in addition to cancer, registered in the five years preceding diagnosis, and polypharmacy as five or more redeemed medications 2–12 months prior to cancer diagnosis. Cox regression analyses were used to estimate the effects of multimorbidity and polypharmacy, as well as the combined effect on mortality. Results: A total of 261,745 cancer patients were included. We found that patients diagnosed with breast, prostate, colon, rectal, oropharynx, bladder, uterine and cervical cancer, malignant melanoma, Non-Hodgkin lymphoma, and leukemia had higher mortality when the cancer diagnosis was accompanied by multimorbidity and polypharmacy, while in patients with cancer of the lung, esophagus, stomach, liver, pancreas, kidney, ovarian and brain & central nervous system, these factors had less impact on mortality. Conclusion: We found that multimorbidity and polypharmacy was associated with higher mortality in patients diagnosed with cancer types that typically have a favorable prognosis compared with patients without multimorbidity and polypharmacy. Multimorbidity and polypharmacy had less impact on mortality in cancers that typically have a poor prognosis.

KW - Mortality

KW - multimorbidity

KW - polypharmacy

KW - prognosis

U2 - 10.1080/0284186X.2023.2270145

DO - 10.1080/0284186X.2023.2270145

M3 - Journal article

C2 - 37874076

AN - SCOPUS:85174639119

VL - 62

SP - 1653

EP - 1660

JO - Acta Oncologica

JF - Acta Oncologica

SN - 1100-1704

IS - 12

ER -