PURPOSE: To describe the annual prevalence of cardiovascular and endocrine comorbidities in adults admitted to U.S. hospitals from 1996 to 2008 with lung, breast, prostate, or colorectal cancer.
METHODS: We analyzed data in the National Hospital Discharge Surveys; conducted annually by the U.S. Centers for Disease Control and Prevention. ICD-9-CM codes were used to identify hospital visits with a principal discharge diagnosis of lung (162), breast (174), prostate (185), or colorectal (153) cancer. This analysis was limited to patients at least 18 years of age. Five chronic comorbidities were quantified: diabetes (250), ischemic heart disease (410-414), heart failure (428), cerebrovascular disease (430-438), and lipid disorders (272). We divided patients into groups based on cancer type and calculated the prevalence of each comorbidity for each survey year.
RESULTS: These data represent 5.7 million hospital visits for lung (1.9), breast (1.2), prostate (1.2), and colorectal (1.4) cancer. Comorbidity rates for the 13-year study period were: lung (diabetes 10%, ischemic heart disease 12%, heart failure 8%, cerebrovascular disease 2%, and lipid disorders 6%), breast (10%, 5%, 3%, 1%, 6%), prostate (10%, 11%, 3%, 1%, 12%), and colorectal (12%, 11%, 7%, 2%, 7%) cancer. Lung cancer patients experienced an increase in diabetes (3%) and lipid disorders (8%) while breast cancer patients experienced increases in ischemic heart disease (4%) and lipid disorders (9%). Prostate and colorectal cancer patients also experienced an increase in lipid disorders (18% and 9%, respectively).
CONCLUSIONS: Cardiovascular and endocrine comorbidities are on the rise in patients admitted to U.S. hospitals with lung, breast, prostate, and colorectal cancer.
CLINICAL IMPLICATIONS: These findings have major implications for cancer prognosis and treatment. Future cancer care will increasingly involve chronic disease management and attention to drug-drug interactions.
DISCLOSURE: Bradi Frei: Consultant fee, speaker bureau, advisory committee, etc.: Served on advisory board for Sanofi Aventis
The following authors have nothing to disclose: Christopher Frei
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