Socioeconomic Disparities in Comorbidity Burden among Adults with Cancer

In a study, researchers evaluated socioeconomic disparities associated with the prevalence of comorbid chronic conditions among adults with cancer. These data were published in Acta Oncologica.

For this analysis, the team utilized the Canadian Community Health Survey dataset from the years 2017 to 2018. Overall, 104,362 participants were included in the study, including 10,782 patients with a history of cancer. Ten chronic comorbid conditions were assessed for prevalence among the cohort: asthma, chronic obstructive pulmonary disease (COPD), arthritis, hypertension, hypercholesterolemia/hyperlipidemia, heart disease, stroke, diabetes, mood disorder, and anxiety disorder. Patients were stratified according to age, sex, and race. The investigators utilized multivariable logistic regression to assess the association between sociodemographic characteristics, and the presence of multiple comorbid conditions

A history of cancer was found to be associated with a higher likelihood of having multiple comorbidities, the researchers reported. This relationship was observed regardless of patient age, sex, or race (all P<0.05). Arthritis was the most common condition among patients with cancer, occurring in 40.2% of the population. The second most common condition was hypertension (36.1%), followed by hypercholesterolemia (25.2%). The most common triad of comorbidities was cancer, arthritis, and hypertension, which occurred in 17.7% of patients.

According to multivariable logistic regression analysis, several sociodemographic factors were associated with the presence of multiple comorbidities. The researchers found that being older than the age of 80 was associated with a higher likelihood of multiple chronic conditions compared to patients aged 18–20 years (odds ratio [OR]= 8.32; 95% confidence interval [CI], 5.17-13.39). Patients who were an indigenous racial group also had higher odds of multiple comorbidities compared with other races (OR=1.94; 95% CI, 1.43-2.63). Additionally, patients with an income of at least $80,000 (Canadian dollars) had a reduced likelihood of multiple conditions than patients with an annual income of less than $20,000 (OR=0.29; 95% CI, 0.23-0.37).

In conclusion, the authors wrote, “History of cancer is associated with a higher probability of many comorbid conditions. This excess comorbidity burden seems to be unequally shouldered by individuals in the lower socioeconomic stratum as well as minority populations.”