Background: Cancer, its treatment, and associated adverse effects may accelerate the functional aging of cancer survivors. In the current study, the authors used geriatric assessment (GA) to compare the functional age of long-term cancer survivors with that of similarly aged women without a cancer history, and to examine whether functional age influences all-cause mortality differently between these 2 groups. Methods: Participants included 1723 cancer survivors and 11,145 age-matched, cancer-free women enrolled in the Iowa Women's Health Study in 1986 who completed the 2004 questionnaire (at ages 73-88 years). GA domain deficits included ≥2 physical function limitations, ≥2 comorbidities, poor general health, poor mental health, and underweight. The risk of all-cause mortality was estimated for deficits in each GA domain between 4 groups based on the cross-classification of the presence and/or absence of cancer history and GA domain deficit (the referent group was cancer-free women without a GA deficit). Results: Both cancer history and GA domain deficits significantly predicted 10-year mortality for all GA domains. Cancer survivors without deficits had a 1.3-fold to 1.4-fold risk of mortality, similar to the 1.1-fold to 1.7-fold risk noted among cancer-free women with deficits (all P <.05). Cancer survivors with deficits were found to have the highest mortality risk for 4 of 5 domains (hazard ratio range, 1.6-2.0). Mortality risk increased with the increasing number of GA deficits, which was greater in cancer survivors compared with cancer-free women. Conclusions: Even without GA deficits, cancer survivors appear to have an excess risk of death compared with women without cancer, and these deficits add to mortality risk. Interventions are needed to maintain or improve functional/physiological capacity as women age, especially in cancer survivors.
Bibliographical noteFunding Information:
Kim Robien has received grant R01 CA39742 from the National Cancer Institute of the National Institutes of Health for work performed as part of the current study. DeAnn Lazovich has received a grant from the National Institutes of Health for work performed as part of the current study. The other authors made no disclosures. Funding was provided by the National Cancer Institute of the National Institutes of Health (grants R01 CA039742 [principal investigator (PI): DeAnn Lazovich; previous PI: Kim Robien] and K07 CA215937 [PI: Cindy K Blair]), the University of Minnesota Cancer Center, and the University of New Mexico Comprehensive Cancer Center.
- cancer history
- cancer survivorship
- functional age
- geriatric assessment