ASPO Abstracts
Impact of Medical Comorbidities on Health-Related Quality of Life in Older Adults with Pancreatic Adenocarcinoma: An Analysis using the 1998-2011 SEER-MHOS Data
Category: Survivorship & Health Outcomes/Comparative Effectiveness Research
Conference Year: 2019
Abstract Body:
Purpose: To examine the impact of medical comorbidities on health-related quality of life (HRQOL) in older adults with pancreatic ductal adenocarcinoma (PDAC) and individuals without cancer using a population-based dataset. Methods: We conducted a retrospective case-control study using the National Cancer Institute’s 1998-2011 Surveillance, Epidemiology, and End Results-Medicare Health Outcomes Survey (SEER-MHOS) linked cohort dataset. Cases were Medicare beneficiaries aged 65 and older diagnosed with PDAC (N = 128) and controls were individuals without a history of cancer (N = 512). Controls were matched 4:1 on age, sex, race/ethnicity, and cohort study year. HRQOL was examined using the Short Form 36 (SF-36) and Veterans-RAND-12 (VR-12). Algorithms were used to equate component summary scores on mental health (MCS) and physical health (PCS) from the SF-36 to the VR-12. Mixed effect models were used to examine the impact of medical comorbidities on MCS and PCS for controls and linear regression models were used for cases. Models were adjusted for sociodemographic and survey response characteristics. Results: Patients with PDAC reported significantly poorer PCS (25.1 vs. 35.4) and MCS (42.2 vs. 49.0) scores compared to matched controls without cancer, p<.0001. Cardiopulmonary disease (β = -6.10), musculoskeletal pain (β = -7.82), diabetes (β =-6.27), and total number of comorbidities (β = -3.10) significantly contributed to poorer PCS scores in controls (p<.0001), but not in PDAC cases. Similarly, cardiopulmonary disease (β = -2.54), musculoskeletal pain (β = -3.71) and total number of comorbidities(β= -1.54) significantly contributed to poorer MCS scores in controls, but not in cases.Diabetes was not a significant contributing factor to MCS scores in cases or controls. Conclusions: Pancreatic cancer is associated with significantly lower HRQOL. Although medical comorbidities are significantly related to poorer HRQOL in older adults without a history of cancer, the additive effect of comorbidities on patients with PDAC does not appear to impact HRQOL.
Keywords: Pancreatic cancer, comorbidities, quality of life