Comorbidity in aging and cancer

Abstract

Comorbidity, the presence of coexisting diseases, is common in older adults with cancer. However, measurement of comorbidity is challenging due to its manifold presentation; numerous measures have been developed and validated, but there is no “gold standard” for comorbidity measurement in patients with cancer. However, a few tools have been developed specifically for quantification of comorbidity in older adults and/or patients with cancer. Comorbidity has complex interactions with cancer risk, prognosis, cancer treatment decisions, and tolerability of cancer treatment. For older adults in particular, comorbidity can imply “competing risks” for mortality and therefore a projected lack of benefit for anticancer therapies; on the other hand, comorbidity is not always associated with worse outcomes from these therapies. Comprehensive geriatric assessment (CGA) along with assessment of patients’ goals and overall life expectancy can assist with decision-making in older adults with cancer and comorbidity.