Open Access Research article

Decreased survival among lung cancer patients with co-morbid tuberculosis and diabetes

Shwn-Huey Shieh12, Janice C Probst3, Fung-Chang Sung45, Wen-Chen Tsai1, Ya-Shin Li6 and Chih-Yi Chen78*

Author Affiliations

1 Department of Health Services Administration, China Medical University, Taichung, 40402, Taiwan

2 Department of Nursing, China Medical University Hospital, Taichung, 40402, Taiwan

3 Department of Health Services Policy and Management, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA

4 Department of Public Health, China Medical University, Taichung, 40402, Taiwan

5 Department of Medical Research, China Medical University Hospital, Taichung, 40402, Taiwan

6 Department of Health Systems Management, Chung-Shan Medical University and Hospital, Taichung, 40201, Taiwan

7 Department of Respiratory Therapy, China Medical University, Taichung, 40402, Taiwan

8 Cancer center, China Medical University Hospital, 2 Yu Der Road, Taichung, 40402, Taiwan

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BMC Cancer 2012, 12:174  doi:10.1186/1471-2407-12-174

Published: 11 May 2012

Abstract

Background

Comorbid conditions influence the survival of cancer patients. This study evaluated the influence of comorbidity on survival among lung cancer patients.

Methods

The authors evaluated the medical records of 1111 lung cancer patients of a medical center in Taiwan. Days of survival were calculated for each patient and mortality hazard ratios were estimated for associations with demographic status, comorbidity and cancer stage at diagnosis.

Results

On average, the survival time was slightly longer among women than among men (838 ± 689 vs. 749 ± 654 days, p = 0.050). Survival days increased with age (from 580 ± 526 [≤ 50 years] to 803 ± 693 [≥ 71 years] days, p = 0.020) and decreased with stage (from 1224 ± 656 [stage I] to 489 ± 536 [stage IV] days, p < 0.001). Younger patients were more likely to be diagnosed with lung cancer at a late stage. Compared with lung cancer patients without tuberculosis, those with tuberculosis had a significantly shorter average survival duration (584 vs. 791 days, p = 0.002) and a higher mortality hazard ratio (1.30, 95% CI: 1.03 - 1.65). A similar trend was observed in lung cancer patients with diabetes.

Conclusions

Lung cancer patients with comorbid tuberculosis or diabetes are at an elevated risk of mortality. These patients deserve greater attention while undergoing cancer treatment.

Keywords:
Lung cancer; Comorbidity; Diabetes; Survival; Tuberculosis