NDLI: Prognostic impact of comorbidity among long-term breast cancer survivors: results from the LACE study.

Content Provider	World Health Organization (WHO)-Global Index Medicus
Author	Braithwaite, Dejana Moore, Dan H. Satariano, William A. Kwan, Marilyn L. Hiatt, Robert A. Kroenke, Candyce Caan, Bette J.
Spatial Coverage	California
Description	Country affiliation: United States Author Affiliation: Braithwaite D ( Department of Epidemiology and Biostatistics and Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco, San Francisco, CA 94107, USA. DBraithwaite@epi.ucsf.edu)
Abstract	BACKGROUND: Little is known about the long-term impact of comorbidity among women with breast cancer. METHODS: We studied a prospective cohort of 2,272 women with breast cancer, who were recruited following initial breast cancer treatment. Associations of the Charlson comorbidity index (CCI) and hypertension with survival were evaluated in delayed entry Cox proportional hazards models. RESULTS: During a median follow-up of nine years, higher CCI scores were independently associated with an increased risk of death from all causes [HR, 1.32; 95% confidence interval (CI), 1.13-1.54] and from nonbreast cancer causes (HR, 1.55; 95% CI, 1.19-2.02), but not from breast cancer (HR, 1.14; 95% CI, 0.93-1.41). Hypertension was independently associated with an increased risk of death from all causes (HR, 1.55; 95% CI, 1.20-1.99), from nonbreast cancer causes (HR, 1.67; 95% CI, 1.10-2.54), and from breast cancer (HR, 1.47; 95% CI, 1.03-2.09), but these associations were no longer significant after adjustment for antihypertensive medication. The relationship between the CCI and overall survival was the strongest among women with stage I disease (stage I, HR, 1.65; 95% CI, 1.26-2.16 vs. stage III, HR, 0.53; 95% CI, 0.23-1.25). CONCLUSION: The CCI was independently associated with lower overall and nonbreast cancer survival, but not with breast cancer-specific survival. IMPACT: Comorbidity may play an important role in breast cancer outcomes.
File Format	HTM / HTML
ISSN	10559965
e-ISSN	15387755
DOI	10.1158/1055-9965.EPI-11-1228
Journal	Cancer Epidemiology Biomarkers & Prevention
Issue Number	7
Volume Number	21
Language	English
Publisher	American Association for Cancer Research
Publisher Date	2012-07-01
Publisher Place	United States
Access Restriction	Open
Subject Keyword	Discipline Cancer epidemiology Breast Neoplasms Epidemiology Mortality Survivors Diagnosis Comorbidity Neoplasm Staging Prognosis Risk Factors Survival Rate Research Support, N.i.h., Extramural Research Support, Non-u.s. Gov't
Content Type	Text
Resource Type	Article
Subject	Epidemiology Oncology

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