The Impact of Comorbidity and Stage on Ovarian Cancer Mortality: A Nationwide Danish Cohort Study


Show simple item record Tetsche, Mette S en_US Dethlefsen, Claus en_US Pedersen, Lars en_US Sorensen, Henrik T en_US Norgaard, Mette en_US 2012-01-11T22:21:31Z 2012-01-11T22:21:31Z 2008 en_US 2008-1-29 en_US
dc.identifier.citation Tetsche, Mette S, Claus Dethlefsen, Lars Pedersen, Henrik T Sorensen, Mette Norgaard. "The impact of comorbidity and stage on ovarian cancer mortality: A nationwide Danish cohort study" BMC Cancer 8:31. (2008) en_US
dc.identifier.issn 1471-2407 en_US
dc.description.abstract BACKGROUND. The incidence of ovarian cancer increases sharply with age, and many elderly patients have coexisting diseases. If patients with comorbidities are diagnosed with advanced stages, this would explain the poor survival observed among ovarian cancer patients with severe comorbidity. Our aims were to examine the prevalence of comorbidity according to stage of cancer at diagnosis, to estimate the impact of comorbidity on survival, and to examine whether the impact of comorbidity on survival varies by stage. METHODS. From the Danish Cancer Registry we identified 5,213 patients (> 15 years old) with ovarian cancer diagnosed from 1995 to 2003. We obtained information on comorbidities from the Danish National Hospital Discharge Registry. Vital status was determined through linkage to the Civil Registration System. We estimated the prevalence of comorbidity by stage and computed absolute survival and relative mortality rate ratios (MRRs) by comorbidity level (Charlson Index score 0, 1–2, 3+), using patients with Charlson Index score 0 as the reference group. We then stratified by stage and computed the absolute survival and MRRs according to comorbidity level, using patients with Charlson score 0 and localized tumour/FIGO I as the reference group. We adjusted for age and calendar time. RESULTS. Comorbidity was more common among patients with an advanced stage of cancer. One- and five-year survival was higher in patients without comorbidity than in patients with registered comorbidity. After adjustment for age and calendar time, one-year MRRs declined from 1.8 to 1.4 and from 2.7 to 2.0, for patients with Charlson scores 1–2 and 3+, respectively. After adjustment for stage, the MRRs further declined to 1.3 and 1.8, respectively. Five-year MRRs declined similarly after adjustment for age, calendar time, and stage. The impact of severe comorbidity on mortality varied by stage, particularly among patients with tumours with regional spread/FIGO-stages II and III. CONCLUSION. The presence of severe comorbidity was associated with an advanced stage of ovarian cancer. Mortality was higher among patients with comorbidities and the impact of comorbidity varied by stage. en_US
dc.description.sponsorship Western Danish Research Forum for Health Sciences; Research Foundation of Northenr Jutland; Research Initiative of Aarhus University Hospital; Ebba and Aksel Schølin Foundation; Peder Kristian Tøftings and Dagmar Tøftings Foundation; Heinrich Kopps Foundation; Herta Christensens Foundation; Karen Elise Jensen Foundation; Institute of Clinical Medicine, Aarhus University; Danish Cancer Society en_US
dc.language.iso en en_US
dc.publisher BioMed Central en_US
dc.rights Copyright 2008 Tetsche et al; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. en_US
dc.rights.uri en_US
dc.title The Impact of Comorbidity and Stage on Ovarian Cancer Mortality: A Nationwide Danish Cohort Study en_US
dc.type article en_US
dc.identifier.doi 10.1186/1471-2407-8-31 en_US
dc.identifier.pubmedid 18230177 en_US
dc.identifier.pmcid 2266760 en_US

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