When it comes to cancer prognosis, it's not just the tumor that matters

St. Louis, May 25, 2004 -- Findings from a new cancer study may seem obvious -- a patient's overall health is a critical factor in assessing prognosis. But the study's authors say data about patients' non-cancer ailments, called comorbidities, are not currently incorporated into cancer statistics.

The study will appear in the May 26 issue of the Journal of the American Medical Association.

Physicians intuitively use a patient's overall health when determining the best course of treatment, but records used to track and study cancer data focus on tumor size and typically ignore comorbidity statistics, according to principal investigator Jay F. Piccirillo, M.D. Those omissions put both clinical trials and cancer physicians at a disadvantage.

"Only 5 percent of adults with cancer are treated in clinical trials, so many treatments are assessed from the study of routine patient care information recorded in cancer registries rather than through controlled clinical trials," says Piccirillo, who is an associate professor of otolaryngology and of medicine at Washington University School of Medicine and Siteman Cancer Center in St. Louis. "We therefore need to incorporate comorbidity statistics into cancer registry records to make our data more accurate and, by extension, to help clinicians determine the best treatments for cancer patients."

In 1995, Piccirillo and his colleagues trained cancer registrars to record comorbidity information during the normal process of documenting cancer cases at the School of Medicine's clinical affiliate, Barnes-Jewish Hospital. The process incorporates the 27 most common comorbid ailments, including the severity level of these conditions on a four-point scale. Registrars combine this information with data they already collect, including tumor size and type.

Their latest study presents findings based on the more than 17,700 patients in the Barnes-Jewish Hospital cancer registry whose comorbidity infor

Contact: Gila Z. Reckess
Washington University School of Medicine

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