International Journal of Environmental Research and Public Health

Journal Browser

► Journal Browser

Co-morbidities, Co-medications and Cancer

Share This Special Issue

Special Issue Editor

Dr. Sandar Tin Tin

E-Mail Website1 Website2
Guest Editor

1. Section of Epidemiology and Biostatistics, School of Population Health, University of Auckland, Auckland, New Zealand;
2. Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK
Interests: epidemiology; cancer; co-morbidity; medication use; health care delivery; equity; lifestyle factors; risks; outcomes

Special Issue Information

Dear Colleagues,

Cancer is common and rising as the population ages. It is becoming a chronic disease as cancer survival rates are improving with advances in diagnosis and treatment options. As a result, cancer patients are increasingly burdened with comorbidities such as cardiovascular disease and diabetes, which may increase their risk of being exposed to polypharmacy, i.e., the simultaneous use of multiple drugs.

Comorbidities and associated medication use may have an impact on cancer treatments and outcomes. For example, patients with comorbidities may be less likely to receive definitive cancer treatment and experience poorer survival outcomes. Polypharmacy may increase the risk of drug–drug interactions which may result in increased drug-related toxicity or impaired treatment efficacy, thereby impacting survival outcomes. On the other hand, certain noncancer medications such as metformin appear to have a positive effect on cancer outcomes.

This Topical Collection is open to the subject area of comorbidities, co-medications, and cancer. The keywords listed below provide an outline of some of the possible areas of interest.

Dr. Sandar Tin Tin
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. International Journal of Environmental Research and Public Health is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2500 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Benefits of Publishing in a Special Issue

Ease of navigation: Grouping papers by topic helps scholars navigate broad scope journals more efficiently.

Greater discoverability: Special Issues support the reach and impact of scientific research. Articles in Special Issues are more discoverable and cited more frequently.

Expansion of research network: Special Issues facilitate connections among authors, fostering scientific collaborations.

External promotion: Articles in Special Issues are often promoted through the journal's social media, increasing their visibility.

Reprint: MDPI Books provides the opportunity to republish successful Special Issues in book format, both online and in print.

Further information on MDPI's Special Issue policies can be found here.

Published Papers (2 papers)

Download All Papers

Order results

Result details

Show export options Show export options

Select all

Export citation of selected articles as:

Research

12 pages, 2159 KiB

Open AccessArticle

Use of Non-Cancer Medications in New Zealand Women at the Diagnosis of Primary Invasive Breast Cancer: Prevalence, Associated Factors and Effects on Survival

by Phyu Sin Aye, Oliver W. Scott, J. Mark Elwood, Diana Sarfati, Ross Lawrenson, Ian D. Campbell, Marion Kuper-Hommel and Sandar Tin Tin

Int. J. Environ. Res. Public Health 2020, 17(21), 7962; https://doi.org/10.3390/ijerph17217962 - 29 Oct 2020

Cited by 2 | Viewed by 2276

Abstract

Background: Assessing the use of multiple medications in cancer patients is crucial as such use may affect cancer outcomes. This study reports the prevalence of non-cancer medication use at breast cancer diagnosis, its associated factors, and its effect on survival. Methods: We identified all women diagnosed with primary invasive breast cancer between 1 January 2007 and 31 December 2016, from four population-based breast cancer registries, in Auckland, Waikato, Wellington, and Christchurch, New Zealand. Through linkage to the pharmaceutical records, we obtained information on non-cancer medications that were dispensed for a minimum of 90 days’ supply between one year before cancer diagnosis and first cancer treatment. We performed ordered logistic regressions to identify associated factors and Cox regressions to investigate its effect on patient survival. Results: Of 14,485 patients, 52% were dispensed at least one drug (mean—1.3 drugs; maximum—13 drugs), with a higher prevalence observed in patients who were older, treated at a public facility, more economically deprived, and screen-detected. The use of 2–3 drugs showed a reduced non-breast cancer mortality (HR = 0.75, 95%CI = 0.60–0.92) in previously hospitalised patients, with other groups showing non-significant associations when adjusted for confounding factors. Drug use was not associated with changes in breast cancer-specific mortality. Conclusions: Non-cancer medication use at breast cancer diagnosis was common in New Zealand, more prevalent in older and disadvantaged women, and showed no effect on breast cancer-specific mortality, but a reduction in other cause mortality with the use of 2–3 drugs. Full article

(This article belongs to the Special Issue Co-morbidities, Co-medications and Cancer)

► Show Figures

Figure 1

22 pages, 1327 KiB

Open AccessArticle

Availability, Price and Affordability of Anticancer Medicines: Evidence from Two Cross-Sectional Surveys in the Jiangsu Province, China

by Yulei Zhu, Ying Wang, Xiaoluan Sun and Xin Li

Int. J. Environ. Res. Public Health 2019, 16(19), 3728; https://doi.org/10.3390/ijerph16193728 - 3 Oct 2019

Cited by 28 | Viewed by 4123

Abstract

Objectives: With the increasing incidence of cancer, poor access to affordable anticancer medicines has been a serious public health problem in China. To help address this issue, we assessed the availability, price and affordability of pharmacotherapy for cancer in public hospitals in the Jiangsu Province, China. Methods: In 2012 and 2016, anticancer medicine availability and price information in the capital and five other cities was collected. A total of six cancer care hospitals, 26 tertiary general hospitals and 28 secondary general hospitals were sampled, using an adaptation of the World Health Organization/Health Action International methodology. Data was collected for the anticancer medicines in stock at the time of the surveys. Prices were expressed as inflation-adjusted median unit prices (MUPs). Medicine was affordable if the overall cost of all the prescribed anticancer medicines was less than 20% of the household’s capacity to pay. We used generalized estimating equations to estimate the significance of differences in availability from 2012 to 2016 and the Wilcoxon rank test to estimate the significance of differences in MUPs. Multivariate logistic regression was computed to measure predictors of affordability. Results: From 2012 to 2016 there was a significant decrease in the mean availability of originator brands (OBs) (from 7.79% to 5.71%, p = 0.012) and lowest-priced generics (LPGs) (36.29% to 32.67%, p = 0.009). The mean availability of anticancer medicines in secondary general hospitals was significantly lower than the cancer care, as well as in tertiary general hospitals. The MUPs of OBs (difference: −21.29%, p < 0.01) and their LPGs (−22.63%, p < 0.01) decreased significantly from 2012 to 2016. The OBs (16.67%) of all the anticancer medicines were found to be less affordable than LPGs (34.62% for urban residents and 30.77% for rural residents); their affordability varied among the different income regions. From 2012 to 2016, the proportion of LPGs with low availability and low affordability dropped from 30.77% to 19.23% in urban areas and 34.62% to 26.92% in rural areas, respectively. Generic substitution and medicine covered by basic medical insurance are factors facilitating affordability. Conclusion: There were concerning decreases in the availability of anticancer medicines in 2016 from already low availability in 2012. Anticancer medicines were more affordable for the patients in high-income regions than the patients in low-income regions. Governments should consider using their bargaining power to reduce procurement prices and abolish taxes on anticancer medicines. Policy should focus on the special health insurance plan for low-income patients with cancer. The goal of drug policy should ensure that first-line generic drugs are available for cancer patients and preferentially prescribed. Full article

(This article belongs to the Special Issue Co-morbidities, Co-medications and Cancer)

► Show Figures

Journal Menu

Journal Browser

Co-morbidities, Co-medications and Cancer

Share This Special Issue

Special Issue Editor

Special Issue Information

Keywords

Benefits of Publishing in a Special Issue

Published Papers (2 papers)

Research

Further Information

Guidelines

MDPI Initiatives

Follow MDPI