History of cancer and mortality in community-dwelling older adults.

Pubmed ID: 20708995

Pubmed Central ID: PMC3062071

Journal: Cancer epidemiology

Publication Date: Feb. 1, 2011

Affiliation: VA Medical Center, Birmingham, AL, USA.

MeSH Terms: Humans, Male, Adult, Female, Aged, Risk Factors, Cohort Studies, Age Factors, Prospective Studies, Survival Rate, Residence Characteristics, Neoplasms

Grants: R01 HL085561, R01-HL085561, R01 HL085561-04, R01 HL097047, R01 HL097047-02, R01-HL097047

Authors: Ekundayo OJ, Love TE, Aban I, Ahmed A, Zhang Y, Ritchie C, Kvale E, Akhter S

Cite As: Kvale E, Ekundayo OJ, Zhang Y, Akhter S, Aban I, Love TE, Ritchie C, Ahmed A. History of cancer and mortality in community-dwelling older adults. Cancer Epidemiol 2011 Feb;35(1):30-6. Epub 2010 Aug 13.



BACKGROUND: The association between a history of cancer and mortality has not been studied in a propensity-matched population of community-dwelling older adults. METHODS: Of the 5795 participants in the Cardiovascular Health Study, 827 (14%) had self-reported physician-diagnosed cancer at baseline. Propensity scores for cancer were used to assemble a cohort of 789 and 3118 participants with and without cancer respectively who were balanced on 45 baseline characteristics. Cox regression models were used to determine the association between cancer and all-cause mortality among matched patients, and to identify independent predictors of mortality among unmatched cancer patients. RESULTS: Matched participants had a mean (SD) age of 74 (6) years, 57% were women, 10% were African Americans, and 38% died from all causes during 12 years of follow-up. All-cause mortality occurred in 41% and 37% of matched participants with and without a history of cancer respectively (hazard ratio when cancer was compared with no cancer, 1.16; 95% confidence interval, 1.02-1.31; P=0.019). Among those with cancer, older age, male gender, smoking, lower than college education, fair-to-poor self-reported health, coronary artery disease, diabetes mellitus, chronic kidney disease, left ventricular hypertrophy, increased heart rate, low hemoglobin and low baseline albumin were associated with increased risk of mortality. CONCLUSIONS: Among community-dwelling older adults, a history of cancer was associated with increased mortality and among those with cancer, several socio-demographic variables and morbidities predicted mortality. These findings suggest that addressing traditional risk factors for cardiovascular mortality may help improve outcomes in older adults with a history of cancer.