Older asthmatics have increased cancer risk

New research shows that older adults with asthma are at an increased risk for developing cancer, and adults with asthma are twice as likely to suffer from heart disease and other chronic health conditions.

A study in the February issue of CHEST, the peer-reviewed journal of the American College of Chest Physicians (ACCP), shows that adults with asthma over age 55 have an increased risk of developing cancer, compared with adults without asthma. Furthermore, the study shows that adults with asthma are twice as likely than those without asthma to suffer from at least one comorbid chronic condition, including heart disease, diabetes, arthritis, stroke, cancer, and osteoporosis.

"Asthma and allergy-related diseases are usually associated with lower cancer levels. However, our study found an increased cancer risk among older patients with asthma," said the study's lead author Robert J. Adams, MD, The Queen Elizabeth Hospital, University of Adelaide, South Australia.

Australian researchers examined the prevalence of common, chronic medical conditions in adults with and without asthma and how comorbid chronic health conditions affect quality of life. Asthma status, demographics, quality-of-life scores, and information about work/activity impairment were gathered from 7,619 adults in three Australian states. Of those surveyed, 834 adults reported current doctor-diagnosed asthma.

Overall, adults with asthma were twice as likely as those without asthma to report having other chronic conditions, with the most prominent conditions being heart disease and stroke. For those over age 55, cancer was significantly more prominent than in adults under age 55. All other chronic conditions, except diabetes, were significantly more common in older adults with asthma. Among adults with asthma aged between 35 and 54 years, arthritis was substantially increased in frequency.

"Asthma's link to other chronic conditions appears to be age-related. As adults with asthma age, the likelihood of developing other chronic conditions becomes greater," said study co-author Richard E. Ruffin, MD, FCCP, The Queen Elizabeth Hospital, University of Adelaide, South Australia. "Clinicians caring for older adults with asthma need to consider comorbid chronic conditions when developing asthma action plans. Young adults with asthma, who are at risk for developing other chronic conditions, also should be targeted for primary or early secondary prevention of these conditions." Researchers stress that following the principles of a healthy lifestyle, such as healthy eating, good asthma control with minimal medication, and annual medical exams, will help reduce a person's risk of developing chronic health conditions.

Although it is unclear which condition developed first, researchers believe a number of factors may contribute to the co-occurrence of asthma and other chronic conditions.

"It is possible that respiratory problems related to asthma may limit a patient's activity, which can lead to weight gain and associated chronic conditions like diabetes, heart disease, arthritis, and sleep disorders," said Dr. Ruffin. "Depression is common for patients with chronic conditions and may contribute to further decreased health and quality of life."

Overall, people with asthma were more likely to report recent impairment in work or usual activities, decreased physical health, and significant impairment in physical quality of life due to illness. The additional presence of any of the chronic conditions was associated with significant further impairment of physical health and quality of life.

Physical scores also were much lower in people with both asthma and the chronic conditions then would be expected from asthma or a chronic condition alone. The negative impact of combining asthma with other chronic conditions was not seen in adults under 35 but was significant in adults over 35 years and became more marked in those aged 55 years and over.

"Asthma continues to be a major public health concern, contributing to decreased quality of life for patients and increased health-care costs for our communities," said W. Michael Alberts, MD, FCCP, President of the American College of Chest Physicians. "By understanding how asthma relates to other chronic conditions, medical professionals can create comprehensive and more effective asthma management plans for their patients."

CHEST is a peer-reviewed journal published by the ACCP. It is available online each month at www.chestjournal.org. The ACCP represents 16,500 members who provide clinical respiratory, sleep, critical care, and cardiothoracic patient care in the United States and throughout the world. The ACCP's mission is to promote the prevention and treatment of diseases of the chest through leadership, education, research, and communication. For more information about the ACCP, please visit the ACCP Web site at www.chestnet.org.