Cancer comorbidities and hospital admission: A Scottish Routes from Diagnosis analysis


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Emily Moore1,Cheryl Denny2,Kelly Sheil-Davis3,Clare Le Blanc3
1Information Services Division, NHS National Services Scotland, Edinburgh, UK,2Information Services Division,3MacMillan Cancer Support

Abstract

Background

Many people diagnosed with cancer also have comorbid conditions which can impact significantly on their health and quality of life, and may also impact on cancer treatment decisions.  As part of the Scottish Routes from Diagnosis (SRfD) project we investigated secondary care use due to comorbidities in cancer patients at and beyond diagnosis.

Method

We used routinely collected national data to define cohorts of people diagnosed with breast, prostate, colorectal and lung cancers in Scotland in 2012, and linked these to hospital admission records. For persons surviving at least a year after cancer diagnosis, we compared the number, type and main diagnosis of inpatient admissions for periods before (6-18 months) and following (0-12 months) the cancer diagnosis. We excluded the 6 months before diagnosis as admissions immediately preceding cancer diagnosis could be influenced by admissions for symptoms of undiagnosed cancer.

Results

The number of admissions for comorbidity (any non-cancer main diagnosis) more than tripled in the year following cancer diagnosis compared to the previous year in the breast, lung and colorectal cancer cohorts, admissions increased by 125% in the prostate cancer cohort. Not everyone in the cohorts had increased non-cancer admissions– between 23% of individuals (prostate cancer cohort) to 44% (lung cancer cohort) experienced increased non-cancer admissions.

Conclusion

There was a large increase in the total number of admissions for comorbid diagnoses following cancer diagnosis. However, there was substantial variation within the cohorts, with only a fraction of persons contributing to these increased admissions.  Some additional admissions will be due to the consequences of cancer or cancer treatment, others due to pre-existing or newly developing independent conditions. Planned future analyses will investigate the characteristics of the people who had increased non-cancer admissions, and calculate length of stay attributable to comorbidities to further quantify their impact on secondary care use in people living with and beyond cancer.