Poster Presentation Clinical Oncology Society of Australia Annual Scientific Meeting 2019

Psychological/behavioural comorbidities are more common among lung cancer patients than colorectal cancer patients in a regional Victorian hospital setting (#326)

Michael Leach 1 , Cheryl Martin 1 , Ilana Solo 1
  1. Loddon Mallee Integrated Cancer Service (LMICS), Bendigo, VICTORIA, Australia

Aims

In Victoria during 2017, 73% of 2,990 new lung cancer (LC) cases and 66% of 3,910 new CRC cases were in those aged >65 years1. Older people with cancer often present with comorbidities, which may impact treatment and supportive care needs. This study aimed to quantify and compare comorbidities between regional Victorian LC and CRC patients.

 

Methods

The Victorian Cancer Registry (VCR) was used to randomly sample patients diagnosed at a regional Victorian public hospital during 2015 with lung cancer (International Classification of Diseases and Related Health Problems-10 [ICD-10] diagnosis codes C34) or CRC (ICD-10 codes C180-C218). Comorbidity data were sourced from medical records, based on ICD-10 diagnoses and medication indications in Australian Medicines Handbook2. Comorbidities were classified into mutually-exclusive categories used in past research3. The number (%) of patients with each comorbidity type was calculated. The chi-square test for independence was used to compare numbers of patients with comorbidities between LC and CRC. P-values<0.05 were considered significant.

 

Results

There were 75 patients with LC and 57 with CRC. The most common comorbidity category was cardiovascular/blood for LC and CRC patients (71% and 67%, respectively). The next most common categories were musculoskeletal (LC: 36%; CRC: 42%) and respiratory (LC: 41%; CRC: 30%). Proportions of patients with comorbidities were similar between LC and CRC for all comorbidity categories except psychological/behavioural (LC: 32%; CRC: 16%; p=0.03). The greatest differences in specific psychological/behavioural comorbidities were for anxiety (LC: 15%; CRC: <9%) and depression (LC: 23%; CRC: 16%).  

 

Conclusions

In this regional Victorian study, comorbidity levels were high. People with LC had more psychological/behavioural comorbidities than those with CRC. While this finding likely reflects prognosis-related distress and psychological needs among LC patients, it also begs the question: are psychological factors predictors of initial smoking that could be targeted in population-based smoking prevention campaigns?

  1. Thursfield V, Farrugia H. Cancer in Victoria: Statistics & Trends 2017. Cancer Council Victoria, Melbourne 2018.
  2. Rossi, S. Australian Medicines Handbook, AMH Pty Ltd, Adelaide, Australia, 2019.
  3. Inacio MCS, Pratt NL, Roughead EE, Graves SE. Comparing co-morbidities in total joint anthroplasty patients using RxRisk-V, Elixhauser, and Charlson measures: a cross-sectional evaluation. 2015. BMC Musculoskeletal Disorders. 15:385.