Comorbidities in Australian women with hormone-dependent breast cancer: a population-based analysis

Huah Shin Ng, Bogda Koczwara, David M Roder, Theo Niyonsenga, Agnes I Vitry

    Research output: Contribution to journalArticle

    3 Citations (Scopus)

    Abstract

    OBJECTIVE: To compare how frequently selected chronic diseases developed in women with breast cancer receiving endocrine therapy, and in women without cancer. DESIGN, SETTING AND PARTICIPANTS: Retrospective, rolling cohort study, analysing a random 10% sample of Pharmaceutical Benefits Scheme (PBS) data for the period 1 January 2003 - 31 December 2014. Women with breast cancer who first commenced endocrine therapy between January 2004 and December 2011 were identified, and age- and sex-matched (1:10) by comorbidity with control groups of women who did not have a dispensing record for antineoplastic agents during the study period or the comorbidity of interest at baseline. MAIN OUTCOME MEASURES: Development of any of eight pre-selected comorbidities, identified in PBS claims data with the RxRisk-V model. RESULTS: Women with hormone-dependent breast cancer were significantly more likely than women in the control group to develop depression (overall hazard ratio [HR], 1.36; 95% CI, 1.26-1.46), pain or pain-inflammation (HR, 1.30; 95% CI, 1.23-1.38), osteoporosis (overall HR, 1.27; 95% CI, 1.17-1.39), diabetes (HR, 1.24; 95% CI, 1.10-1.41), cardiovascular disorders (overall HR, 1.22; 95% CI, 1.13-1.32), and gastric acid disorders (HR, 1.20; 95% CI, 1.13-1.28). The hazard ratios for developing cardiovascular disorders, depression and osteoporosis were highest during the first year of endocrine therapy. The risk of hyperlipidaemia was lower among women with breast cancer than in the control group (HR, 0.88; 95% CI, 0.81-0.96). There was no significant difference between the two groups in the risk of reactive airway diseases (HR, 1.05; 95% CI, 0.98-1.13). CONCLUSION: Comorbid conditions are more likely to develop in women who have been diagnosed with hormone-dependent breast cancer than in women without cancer. Our results further support the need to develop appropriate models of care to manage the multiple chronic disorders of breast cancer survivors.

    Original languageEnglish
    Pages (from-to)24-28
    Number of pages5
    JournalMedical Journal of Australia
    Volume208
    Issue number1
    DOIs
    Publication statusPublished - 15 Jan 2018

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    Comorbidity
    Hormones
    Breast Neoplasms
    Population
    Control Groups
    Osteoporosis
    Depression
    Pain
    Gastric Acid
    Hyperlipidemias
    Pharmaceutical Preparations
    Antineoplastic Agents
    Survivors
    Neoplasms
    Chronic Disease
    Cohort Studies
    Therapeutics
    Inflammation

    Cite this

    Ng, Huah Shin ; Koczwara, Bogda ; Roder, David M ; Niyonsenga, Theo ; Vitry, Agnes I. / Comorbidities in Australian women with hormone-dependent breast cancer: a population-based analysis. In: Medical Journal of Australia. 2018 ; Vol. 208, No. 1. pp. 24-28.
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    title = "Comorbidities in Australian women with hormone-dependent breast cancer: a population-based analysis",
    abstract = "OBJECTIVE: To compare how frequently selected chronic diseases developed in women with breast cancer receiving endocrine therapy, and in women without cancer. DESIGN, SETTING AND PARTICIPANTS: Retrospective, rolling cohort study, analysing a random 10{\%} sample of Pharmaceutical Benefits Scheme (PBS) data for the period 1 January 2003 - 31 December 2014. Women with breast cancer who first commenced endocrine therapy between January 2004 and December 2011 were identified, and age- and sex-matched (1:10) by comorbidity with control groups of women who did not have a dispensing record for antineoplastic agents during the study period or the comorbidity of interest at baseline. MAIN OUTCOME MEASURES: Development of any of eight pre-selected comorbidities, identified in PBS claims data with the RxRisk-V model. RESULTS: Women with hormone-dependent breast cancer were significantly more likely than women in the control group to develop depression (overall hazard ratio [HR], 1.36; 95{\%} CI, 1.26-1.46), pain or pain-inflammation (HR, 1.30; 95{\%} CI, 1.23-1.38), osteoporosis (overall HR, 1.27; 95{\%} CI, 1.17-1.39), diabetes (HR, 1.24; 95{\%} CI, 1.10-1.41), cardiovascular disorders (overall HR, 1.22; 95{\%} CI, 1.13-1.32), and gastric acid disorders (HR, 1.20; 95{\%} CI, 1.13-1.28). The hazard ratios for developing cardiovascular disorders, depression and osteoporosis were highest during the first year of endocrine therapy. The risk of hyperlipidaemia was lower among women with breast cancer than in the control group (HR, 0.88; 95{\%} CI, 0.81-0.96). There was no significant difference between the two groups in the risk of reactive airway diseases (HR, 1.05; 95{\%} CI, 0.98-1.13). CONCLUSION: Comorbid conditions are more likely to develop in women who have been diagnosed with hormone-dependent breast cancer than in women without cancer. Our results further support the need to develop appropriate models of care to manage the multiple chronic disorders of breast cancer survivors.",
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    Comorbidities in Australian women with hormone-dependent breast cancer: a population-based analysis. / Ng, Huah Shin; Koczwara, Bogda; Roder, David M; Niyonsenga, Theo; Vitry, Agnes I.

    In: Medical Journal of Australia, Vol. 208, No. 1, 15.01.2018, p. 24-28.

    Research output: Contribution to journalArticle

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    T1 - Comorbidities in Australian women with hormone-dependent breast cancer: a population-based analysis

    AU - Ng, Huah Shin

    AU - Koczwara, Bogda

    AU - Roder, David M

    AU - Niyonsenga, Theo

    AU - Vitry, Agnes I

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    N2 - OBJECTIVE: To compare how frequently selected chronic diseases developed in women with breast cancer receiving endocrine therapy, and in women without cancer. DESIGN, SETTING AND PARTICIPANTS: Retrospective, rolling cohort study, analysing a random 10% sample of Pharmaceutical Benefits Scheme (PBS) data for the period 1 January 2003 - 31 December 2014. Women with breast cancer who first commenced endocrine therapy between January 2004 and December 2011 were identified, and age- and sex-matched (1:10) by comorbidity with control groups of women who did not have a dispensing record for antineoplastic agents during the study period or the comorbidity of interest at baseline. MAIN OUTCOME MEASURES: Development of any of eight pre-selected comorbidities, identified in PBS claims data with the RxRisk-V model. RESULTS: Women with hormone-dependent breast cancer were significantly more likely than women in the control group to develop depression (overall hazard ratio [HR], 1.36; 95% CI, 1.26-1.46), pain or pain-inflammation (HR, 1.30; 95% CI, 1.23-1.38), osteoporosis (overall HR, 1.27; 95% CI, 1.17-1.39), diabetes (HR, 1.24; 95% CI, 1.10-1.41), cardiovascular disorders (overall HR, 1.22; 95% CI, 1.13-1.32), and gastric acid disorders (HR, 1.20; 95% CI, 1.13-1.28). The hazard ratios for developing cardiovascular disorders, depression and osteoporosis were highest during the first year of endocrine therapy. The risk of hyperlipidaemia was lower among women with breast cancer than in the control group (HR, 0.88; 95% CI, 0.81-0.96). There was no significant difference between the two groups in the risk of reactive airway diseases (HR, 1.05; 95% CI, 0.98-1.13). CONCLUSION: Comorbid conditions are more likely to develop in women who have been diagnosed with hormone-dependent breast cancer than in women without cancer. Our results further support the need to develop appropriate models of care to manage the multiple chronic disorders of breast cancer survivors.

    AB - OBJECTIVE: To compare how frequently selected chronic diseases developed in women with breast cancer receiving endocrine therapy, and in women without cancer. DESIGN, SETTING AND PARTICIPANTS: Retrospective, rolling cohort study, analysing a random 10% sample of Pharmaceutical Benefits Scheme (PBS) data for the period 1 January 2003 - 31 December 2014. Women with breast cancer who first commenced endocrine therapy between January 2004 and December 2011 were identified, and age- and sex-matched (1:10) by comorbidity with control groups of women who did not have a dispensing record for antineoplastic agents during the study period or the comorbidity of interest at baseline. MAIN OUTCOME MEASURES: Development of any of eight pre-selected comorbidities, identified in PBS claims data with the RxRisk-V model. RESULTS: Women with hormone-dependent breast cancer were significantly more likely than women in the control group to develop depression (overall hazard ratio [HR], 1.36; 95% CI, 1.26-1.46), pain or pain-inflammation (HR, 1.30; 95% CI, 1.23-1.38), osteoporosis (overall HR, 1.27; 95% CI, 1.17-1.39), diabetes (HR, 1.24; 95% CI, 1.10-1.41), cardiovascular disorders (overall HR, 1.22; 95% CI, 1.13-1.32), and gastric acid disorders (HR, 1.20; 95% CI, 1.13-1.28). The hazard ratios for developing cardiovascular disorders, depression and osteoporosis were highest during the first year of endocrine therapy. The risk of hyperlipidaemia was lower among women with breast cancer than in the control group (HR, 0.88; 95% CI, 0.81-0.96). There was no significant difference between the two groups in the risk of reactive airway diseases (HR, 1.05; 95% CI, 0.98-1.13). CONCLUSION: Comorbid conditions are more likely to develop in women who have been diagnosed with hormone-dependent breast cancer than in women without cancer. Our results further support the need to develop appropriate models of care to manage the multiple chronic disorders of breast cancer survivors.

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