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Multimorbidity clusters among long-term breast cancer survivors in Spain: Results of the SURBCAN study

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dc.contributor.author Jansana Riera, Anna
dc.contributor.author Poblador-Plou, Beatriz
dc.contributor.author Gimeno-Miguel, Antonio
dc.contributor.author Lanzuela, Manuela
dc.contributor.author Prados-Torres, Alexandra
dc.contributor.author Domingo, Laia
dc.contributor.author Comas Serrano, Mercè
dc.contributor.author Sanz Cuesta, Teresa
dc.contributor.author Del Cura, Maria Isabel
dc.contributor.author Ibañez, Berta
dc.contributor.author Abizanda, Mercè
dc.contributor.author Duarte Salles, Talita, 1985-
dc.contributor.author Padilla-Ruiz, Maria
dc.contributor.author Redondo, Maximino
dc.contributor.author Castells, Xavier
dc.contributor.author Sala Serra, Maria
dc.contributor.author SURBCAN group
dc.date.accessioned 2021-09-28T06:19:23Z
dc.date.issued 2021
dc.identifier.citation Jansana A, Poblador-Plou B, Gimeno-Miguel A, Lanzuela M, Prados-Torres A, Domingo L, Comas M, Sanz-Cuesta T, Del Cura-Gonzalez I, Ibañez B, Abizanda M, Duarte-Salles T, Padilla-Ruiz M, Redondo M, Castells X, Sala M; SURBCAN Group. Multimorbidity clusters among long-term breast cancer survivors in Spain: Results of the SURBCAN study. Int J Cancer. 2021;149(10):1755-67. DOI: 10.1002/ijc.33736
dc.identifier.issn 0020-7136
dc.identifier.uri http://hdl.handle.net/10230/48513
dc.description.abstract The disease management of long-term breast cancer survivors (BCS) is hampered by the scarce knowledge of multimorbidity patterns. The aim of our study was to identify multimorbidity clusters among long-term BCS and assess their impact on mortality and health services use. We conducted a retrospective study using electronic health records of 6512 BCS from Spain surviving at least 5 years. Hierarchical cluster analysis was used to identify groups of similar patients based on their chronic diagnoses, which were assessed using the Clinical Classifications Software. As a result, multimorbidity clusters were obtained, clinically defined and named according to the comorbidities with higher observed/expected prevalence ratios. Multivariable Cox and negative binomial regression models were fitted to estimate overall mortality risk and probability of contacting health services according to the clusters identified. 83.7% of BCS presented multimorbidity, essential hypertension (34.5%) and obesity and other metabolic disorders (27.4%) being the most prevalent chronic diseases at the beginning of follow-up. Five multimorbidity clusters were identified: C1-unspecific (29.9%), C2-metabolic and neurodegenerative (28.3%), C3-anxiety and fractures (9.7%), C4-musculoskeletal and cardiovascular (9.6%) and C5-thyroid disorders (5.3%). All clusters except C5-thyroid disorders were associated with higher mortality compared to BCS without comorbidities. The risk of mortality in C4 was increased by 64% (adjusted hazard ratio 1.64, 95% confidence interval 1.52-2.07). Stratified analysis showed an increased risk of death among BCS with 5 to 10 years of survival in all clusters. These results help to identify subgroups of long-term BCS with specific needs and mortality risks and to guide BCS clinical practice regarding multimorbidity.
dc.format.mimetype application/pdf
dc.language.iso eng
dc.publisher Wiley
dc.relation.ispartof Int J Cancer. 2021;149(10):1755-67
dc.rights This is the peer reviewed version of the following article: Jansana A, Poblador-Plou B, Gimeno-Miguel A, Lanzuela M, Prados-Torres A, Domingo L, Comas M, Sanz-Cuesta T, Del Cura-Gonzalez I, Ibañez B, Abizanda M, Duarte-Salles T, Padilla-Ruiz M, Redondo M, Castells X, Sala M; SURBCAN Group. Multimorbidity clusters among long-term breast cancer survivors in Spain: Results of the SURBCAN study. Int J Cancer. 2021;149(10):1755-67. DOI: 10.1002/ijc.33736, which has been published in final form at http://dx.doi.org/10.1002/ijc.33736. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Use of Self-Archived Versions.
dc.title Multimorbidity clusters among long-term breast cancer survivors in Spain: Results of the SURBCAN study
dc.type info:eu-repo/semantics/article
dc.identifier.doi http://dx.doi.org/10.1002/ijc.33736
dc.subject.keyword Breast cancer
dc.subject.keyword Cluster analysis
dc.subject.keyword Electronic health records
dc.subject.keyword Multimorbidity
dc.subject.keyword Survival
dc.rights.accessRights info:eu-repo/semantics/openAccess
dc.type.version info:eu-repo/semantics/acceptedVersion

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