The effect of different comorbidities on survival of non-small cells lung cancer patients

Lung. 2015 Apr;193(2):291-7. doi: 10.1007/s00408-014-9675-5. Epub 2014 Dec 17.


Purpose: Primary lung cancer is one of the most common types of cancers. Comorbidity has been shown to be a negative prognostic factor in the overall lung cancer population. The significance of the individual comorbidities is less well known. The purpose of this paper is to investigate the effect of each comorbid disease groups on survival.

Methods: The analysis is based on all patients with NSCLC who were registered in 2009-2011, in total 10,378 patients. To estimate the effect of each comorbidity group on the survival, we fitted a Cox regression model for each comorbidity group adjusting for age, sex, resection, and stage.

Results: Patients with cardiovascular comorbidity have a 30% higher death rate [HR 1.30 with 95% CI (1.13; 1.49)] than patients without comorbidity. Patients with diabetes and patients with cerebrovascular disorders and COPD have a 20% excess mortality than patients without comorbidity: [HR 1.19 with CI (1.02; 1.39) for diabetes, HR 1.18 with CI (1.05; 1.33) for cerebrovascular disorders, and HR 1.20 with CI (1.10; 1.39 for COPD)].

Conclusion: Our study shows the importance of cardiovascular disease in lung cancer. Diabetes, cerebrovascular disorders, and COPD also have a significant impact on survival of NSCLC patients.

MeSH terms

  • Aged
  • Carcinoma, Non-Small-Cell Lung / mortality*
  • Cardiovascular Diseases / epidemiology*
  • Cerebrovascular Disorders / epidemiology*
  • Comorbidity
  • Denmark / epidemiology
  • Diabetes Mellitus / epidemiology*
  • Female
  • Humans
  • Lung Neoplasms / mortality*
  • Male
  • Proportional Hazards Models
  • Pulmonary Disease, Chronic Obstructive / epidemiology*
  • Registries
  • Survival Rate