Chronic disease in men with newly diagnosed cancer: a nested case-control study

Abstract

The authors performed a matched case-control study (1982-2007) nested in a prospective cohort of 22,071 US men to determine the prevalence of chronic diseases of aging in those with newly diagnosed cancer. They matched one control by age to each of 5,622 men who developed cancer over the 25 years of follow-up, as of the date of cancer diagnosis. A modified Charlson score was calculated that reflected comorbidities prior to the matching date, and the authors used conditional logistic regression to determine the odds ratios of various diseases. No substantial differences were found between the scores of cases and controls overall, by cancer subtype, or by age at diagnosis. Overall, men who developed cancer were less likely to have had hypercholesterolemia (odds ratio (OR) = 0.79, 95% confidence interval (CI): 0.72, 0.87) or coronary artery disease (OR = 0.85, 95% CI: 0.77, 0.96). Compared with controls, men with cancers for which there is routine screening had fewer diseases, whereas those with smoking-related cancers had more. Prostate cancer was inversely associated with both coronary artery disease (OR = 0.72, 95% CI: 0.62, 0.84) and diabetes (OR = 0.72, 95% CI: 0.58, 0.89). Overall, men who developed cancer had no more comorbidity or frequent history of chronic disease than their age-matched controls.

Figure 1.

Odds ratios (ORs) and 95% confidence intervals (CIs) for selected comorbidities at the time of cancer diagnosis of US cases and controls in the Physicians’ Health Study, 1982–2007. A) Prostate cancer; B) colorectal cancer; C) lung cancer; D) bladder cancer. Squares: odds ratios for individual comorbidities; lines: 95% confidence intervals; diamond: pooled estimate. The final column shows number of cases and number of controls with the selected comorbidities. CAD, coronary artery disease; CHF, congestive heart failure; degen, degeneration; PVD, peripheral vascular disease.

Figure 1.

Odds ratios (ORs) and 95% confidence intervals (CIs) for selected comorbidities at the time of cancer diagnosis of US cases and controls in the Physicians’ Health Study, 1982–2007. A) Prostate cancer; B) colorectal cancer; C) lung cancer; D) bladder cancer. Squares: odds ratios for individual comorbidities; lines: 95% confidence intervals; diamond: pooled estimate. The final column shows number of cases and number of controls with the selected comorbidities. CAD, coronary artery disease; CHF, congestive heart failure; degen, degeneration; PVD, peripheral vascular disease.

Figure 2.

Odds ratios (ORs) and 95% confidence intervals (CIs) for selected comorbidities in US cancer patients and controls aged 80 years or older in the Physicians’ Health Study, 1982–2007. A) Overall cancer; B) prostate cancer; C) colorectal cancer; D) smoking-related cancer. Squares: odds ratios for individual comorbidities; lines: 95% confidence intervals; diamond: pooled estimate. The final column shows number of cases and number of controls with the selected comorbidities. CAD, coronary artery disease; CHF, congestive heart failure; degen, degeneration; PVD, peripheral vascular disease.

Figure 2.

Odds ratios (ORs) and 95% confidence intervals (CIs) for selected comorbidities in US cancer patients and controls aged 80 years or older in the Physicians’ Health Study, 1982–2007. A) Overall cancer; B) prostate cancer; C) colorectal cancer; D) smoking-related cancer. Squares: odds ratios for individual comorbidities; lines: 95% confidence intervals; diamond: pooled estimate. The final column shows number of cases and number of controls with the selected comorbidities. CAD, coronary artery disease; CHF, congestive heart failure; degen, degeneration; PVD, peripheral vascular disease.