Total burden of disease in cancer patients at diagnosis-a Danish nationwide study of multimorbidity and redeemed medication.

BACKGROUND: Multimorbidity is a growing challenge worldwide. In this nationwide study, we investigated the prevalence of multimorbidity and polypharmacy at the time of diagnosis across 20 cancers. METHODS: We conducted a nationwide register-based cohort study of all Danish residents with a first primary cancer diagnosed between 1 January 2005 and 31 December 2015. Multimorbidity was defined as one or more of 20 conditions (131 specific diagnoses) registered in the Danish National Patient Registry < 5 years before the cancer diagnosis. Polypharmacy was defined as five or more medications registered in the Danish National Prescription Registry and redeemed twice 2-12 months before the cancer diagnosis. RESULTS: We included 261,745 patients with a first primary cancer, of whom 55% had at least one comorbid condition at diagnosis and 27% had two or more. The most prevalent conditions at the time of cancer diagnosis were cardiovascular disease, chronic obstructive pulmonary disease, diabetes, stroke and depression/anxiety disorder. Polypharmacy was present in one-third of the cancer patients with antihypertensives, anti-thrombotic agents, anti-hyperlipidaemic agents, analgesics and diuretics as the most prevalent redeemed medications. CONCLUSION: Among patients with a newly established cancer diagnosis, 55% had at least one comorbid condition and 32% were exposed to polypharmacy.

[The development of a generic guideline for multidisciplinary team conferences in Denmark].

Since 2005 multidisciplinary team conferences (MDT) has been a crucial pivot for the Danish national integrated cancer pathways. Despite the formal decision to implement MDT-conferences, many aspects of this complex organization have never been addressed. In 2014, The Danish Multidisciplinary Cancer Groups (DMCG) provided a workgroup with the task of drafting a Danish national guideline for keeping MDT-conferences. This article presents the process of the workgroup, the background for the final content of the guideline as well as minutes from different parts of the guideline.

[Cardiotoxicity induced by 5-fluorouracil or capecitabine]. / Hjertepåvirkning fra 5-fluorouracil og capecitabin.

5-fluorouracil and capecitabine have significant antineoplastic activity towards various solid tumors. Cardiotoxicity causing angina, arrhythmia and infarction are serious adverse events associated with these agents. The pathogenesis is discussed and symptoms of cardiotoxicity, intervention with nitroglycerine and risk factors as cardiac comorbidity are described. Following cardiotoxicity, lack of alternative active agents may provide grounds to rechallenge with 5-FU. In this situation, dose-modified 5-FU-based chemotherapy supported by medical antiangina prevention is feasible.