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@ARTICLE{Boakye:177405,
author = {D. Boakye and K. Günther and T. Niedermaier$^*$ and U.
Haug and W. Ahrens and R. Nagrani},
title = {{A}ssociations between comorbidities and advanced stage
diagnosis of lung, breast, colorectal, and prostate cancer:
{A} systematic review and meta-analysis.},
journal = {Cancer epidemiology},
volume = {75},
issn = {1877-7821},
address = {Amsterdam [u.a.]},
publisher = {Elsevier},
reportid = {DKFZ-2021-02497},
pages = {102054},
year = {2021},
abstract = {Comorbidities and advanced stage diagnosis (ASD) are both
associated with poorer cancer outcomes, but the association
between comorbidities and ASD is poorly understood. We
summarized epidemiological evidence on the association
between comorbidities and ASD of selected cancers in a
systematic review and meta-analysis. We searched PubMed and
Web of Science databases up to June 3rd, 2021 for studies
assessing the association between comorbidities and ASD of
lung, breast, colorectal, or prostate cancer. Summary odds
ratios (ORs) and $95\%$ confidence intervals $(95\%CIs)$
were calculated using random-effects models. Also, potential
variations in the associations between comorbidities and ASD
by cancer type were investigated using random-effects
meta-regression. Thirty-seven studies were included in this
review, including 8,069,397 lung, breast, colorectal, and
prostate cancer patients overall. The Charlson comorbidity
index score was positively associated with ASD (stages
III-IV) of breast cancer but was inversely associated with
ASD of lung cancer (pinteraction = 0.004). Regarding
specific comorbidities, diabetes was positively associated
with ASD (OR = 1.17, $95\%CI = 1.09-1.26),$ whereas
myocardial infarction was inversely associated with ASD
(OR = 0.84, $95\%CI = 0.75-0.95).$ The association
between renal disease and ASD differed by cancer type
(pinteraction < 0.001). A positive association was found
with prostate cancer (OR = 2.02, $95\%CI = 1.58-2.59)$
and an inverse association with colorectal cancer
(OR = 0.84, $95\%CI = 0.70-1.00).$ In summary, certain
comorbidities (e.g., diabetes) may be positively associated
with ASD of several cancer types. It needs to be clarified
whether closer monitoring for early cancer signs or
screening in these patients is reasonable, considering the
problem of over-diagnosis particularly relevant in patients
with short remaining life expectancy such as those with
comorbidities. Also, evaluation of the cost-benefit
relationship of cancer screening according to the type and
severity of comorbidity (rather than summary scores) may be
beneficial for personalized cancer screening in populations
with chronic diseases.},
subtyp = {Review Article},
keywords = {Advanced stage (Other) / Cancer (Other) / Chronic disease
(Other) / Comorbidity (Other) / Late-stage (Other)},
cin = {C070},
ddc = {610},
cid = {I:(DE-He78)C070-20160331},
pnm = {313 - Krebsrisikofaktoren und Prävention (POF4-313)},
pid = {G:(DE-HGF)POF4-313},
typ = {PUB:(DE-HGF)16},
pubmed = {pmid:34773768},
doi = {10.1016/j.canep.2021.102054},
url = {https://inrepo02.dkfz.de/record/177405},
}