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@ARTICLE{Thong:177921,
      author       = {M. Thong$^*$ and D. Boakye$^*$ and L. Jansen$^*$ and U. M.
                      Martens and J. Chang-Claude$^*$ and M. Hoffmeister$^*$ and
                      H. Brenner$^*$ and V. Arndt$^*$},
      title        = {{C}omorbidities, {R}ather {T}han {O}lder {A}ge, {A}re
                      {S}trongly {A}ssociated {W}ith {H}igher {U}tilization of
                      {H}ealthcare in {C}olorectal {C}ancer {S}urvivors.},
      journal      = {Journal of the National Comprehensive Cancer Network},
      volume       = {20},
      number       = {5},
      issn         = {1540-1405},
      address      = {Cold Spring Harbor, NY},
      publisher    = {Harborside Press},
      reportid     = {DKFZ-2021-02943},
      pages        = {468-478},
      year         = {2022},
      note         = {#EA:C071#LA:C071#},
      abstract     = {Colorectal cancer (CRC) survivors generally have a higher
                      healthcare utilization (HCU) than the general population due
                      to cancer burden. However, it is unclear which factors are
                      associated with this increased uptake. Our study aimed to
                      (1) compare CRC-related and non-CRC visits to general
                      practitioners (GPs) and medical specialists (MSs) by
                      comorbidities, and (2) assess whether HCU differs by
                      demographic, clinical, and psychological factors.We used
                      data from a German population-based cohort of 1,718
                      survivors of stage I-III CRC diagnosed in 2003 through 2010
                      who provided information on HCU at 5-year follow-up.
                      Multivariable linear regression was used to calculate
                      least-square means of CRC-related and non-CRC HCU according
                      to the Charlson comorbidity index and comorbidity cluster,
                      adjusting for relevant demographic, clinical, and
                      psychological characteristics.A higher comorbidity level was
                      associated with more CRC-related MS visits and non-CRC GP
                      visits. In addition to being strongly associated with
                      non-CRC GP visits, comorbidity clusters were associated with
                      CRC-related GP and MS visits, but their association varied
                      by specific cardiometabolic comorbidities. HCU was less
                      dependent on prognostic factors for CRC, such as age and
                      tumor stage, but was strongly associated with disease
                      recurrence, depression, and emotional
                      functioning.Comorbidities, rather than age or tumor stage,
                      were related to HCU, suggesting that CRC survivors use
                      healthcare mainly for reasons other than cancer 5 years
                      postdiagnosis. Improved communication between primary and
                      tertiary healthcare providers could enhance the medical care
                      of cancer survivors with complex health needs and thereby
                      also reduce healthcare costs.},
      cin          = {C071 / C070 / C020 / C120 / HD01},
      ddc          = {610},
      cid          = {I:(DE-He78)C071-20160331 / I:(DE-He78)C070-20160331 /
                      I:(DE-He78)C020-20160331 / I:(DE-He78)C120-20160331 /
                      I:(DE-He78)HD01-20160331},
      pnm          = {313 - Krebsrisikofaktoren und Prävention (POF4-313)},
      pid          = {G:(DE-HGF)POF4-313},
      typ          = {PUB:(DE-HGF)16},
      pubmed       = {pmid:34875626},
      doi          = {10.6004/jnccn.2021.7030},
      url          = {https://inrepo02.dkfz.de/record/177921},
}