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BMC Cancer. 2012; 12: 174.
Published online May 11, 2012. doi:  10.1186/1471-2407-12-174
PMCID: PMC3408323
Decreased survival among lung cancer patients with co-morbid tuberculosis and diabetes
Shwn-Huey Shieh,1,2 Janice C Probst,3 Fung-Chang Sung,4,5 Wen-Chen Tsai,1 Ya-Shin Li,6 and Chih-Yi Chencorresponding author7,8
1Department of Health Services Administration, China Medical University, Taichung, 40402, Taiwan
2Department of Nursing, China Medical University Hospital, Taichung, 40402, Taiwan
3Department of Health Services Policy and Management, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
4Department of Public Health, China Medical University, Taichung, 40402, Taiwan
5Department of Medical Research, China Medical University Hospital, Taichung, 40402, Taiwan
6Department of Health Systems Management, Chung-Shan Medical University and Hospital, Taichung, 40201, Taiwan
7Department of Respiratory Therapy, China Medical University, Taichung, 40402, Taiwan
8Cancer center, China Medical University Hospital, 2 Yu Der Road, Taichung, 40402, Taiwan
corresponding authorCorresponding author.
Shwn-Huey Shieh: shshieh/at/mail.cmu.edu.tw; Janice C Probst: jprobst/at/mailbox.sc.edu; Fung-Chang Sung: fcsung1008/at/yahoo.com; Wen-Chen Tsai: wtsai/at/mail.cmu.edu.tw; Ya-Shin Li: yli/at/csmu.edu.tw; Chih-Yi Chen: micc/at/www.cmuh.org.tw
Received October 7, 2011; Accepted May 11, 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
Articles from BMC Cancer are provided here courtesy of
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