Use of comorbidity indices in patients with any cancer, breast cancer, and human epidermal growth factor receptor-2-positive breast cancer: A systematic review

To identify comorbidity indices that have been validated in cancer populations, with a focus on breast cancer and human epidermal growth factor receptor-2-positive (HER2+) breast cancer. A systematic review of the literature on the use of comorbidity indices in any cancer, breast cancer, and HER2+ b...

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Published inPloS one Vol. 16; no. 6; p. e0252925
Main Authors Salas, Maribel, Henderson, Mackenzie, Sundararajan, Meera, Tu, Nora, Islam, Zahidul, Ebeid, Mina, Horne, Laura
Format Journal Article
LanguageEnglish
Published San Francisco Public Library of Science 18.06.2021
Public Library of Science (PLoS)
Subjects
Blood cancer
Breast cancer
Cancer
Clinical medicine
Clinical trials
Colorectal cancer
Comorbidity
Complications and side effects
Cross-sectional studies
Data analysis
Decisions
Editing
Epidemiology
Epidermal growth factor
ErbB-2 protein
Estrogens
Gastric cancer
Growth factors
Head & neck cancer
Health risks
Medicine and Health Sciences
Methodology
Mortality
Patient outcomes
Patients
Pharmaceutical industry
Pharmacology
Pharmacovigilance
Prostate cancer
Receptors
Research design
Safety
Scholarships & fellowships
Skin cancer
Systematic review
Visualization
United States
United States > US
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Summary:To identify comorbidity indices that have been validated in cancer populations, with a focus on breast cancer and human epidermal growth factor receptor-2-positive (HER2+) breast cancer. A systematic review of the literature on the use of comorbidity indices in any cancer, breast cancer, and HER2+ breast cancer using Ovid and PubMed. The final data set comprised 252 articles (252 any cancer, 39 breast cancer, 7 HER2+ breast cancer). The most common cancers assessed were hematologic and breast, and the most common comorbidity index used was the Charlson Comorbidity Index (CCI) or a CCI derivative. Most validity testing of comorbidity indices used predictive validity based on survival outcomes. Hazard ratios for survival outcomes generally found that a higher comorbidity burden (measured by CCI) increased mortality risk in patients with breast cancer. All breast-cancer studies that validated comorbidity indices used CCI-based indices. Only one article validated a comorbidity index in HER2+ breast cancer. CCI-based indices are the most appropriate indices to use in the general breast-cancer population. There is insufficient validation of any comorbidity index in HER2+ breast cancer to provide a recommendation, indicating a future need to validate these instruments in this population.
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SourceType-Scholarly Journals-1
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Competing Interests: The authors have read the journal’s policy and the authors of this manuscript have the following competing interests: Maribel Salas, Nora Tu, Zahidul Islam, Meera Sundararajan, and Mina Ebeid are employees of Daiichi Sankyo, Inc. (the funder of this research). Maribel Salas is also affiliated with the Center for Clinical Epidemiology and Biostatistics. Laura Horne has been hired as a consultant to Daiichi Sankyo, Inc. Mackenzie Henderson is an employee of Rutgers University, NJ, USA, and is contracted to work at Daiichi Sankyo Inc. This does not alter our adherence to PLOS ONE policies on sharing data and materials.
ISSN:1932-6203
1932-6203
DOI:10.1371/journal.pone.0252925