Comorbidities, medication use, and overall survival in eight cancers: a multinational cohort study of 1.7 million patients across Europe
Year: 2026
Type: article
Study design: Observational Study
Abstract: Background: Real-world evidence provides valuable insights into cancer burden, presentation, and care variations. Through a large-scale federated approach, this study aims to explore patient characteristics and overall survival for eight cancers using data from 11 electronic health records and cancer registries from eight European countries, mapped to the Observational Medical Outcomes Partnership Common Data Model (OMOP-CDM). Methods: Patients aged 18 years or older with a primary cancer diagnosis between 2000 and 2019 were included. Patients were followed from cancer diagnosis until death, database exit, or study end. Mortality data was sourced from linked national or subnational death registries for most databases. Patient characteristics, including comorbidities, and medication use, were summarised. Age-standardised overall survival (OS) at one, five, and ten years were calculated using the Kaplan-Meier method and stratified by cancer type, age group and sex. Findings: There were 1,796,278 eligible cancer patients included with most diagnoses in individuals aged 60-79 years. Top comorbidities and medications were relatively consistent across databases, with certain variations observed by cancer type, possibly indicative of early cancer signs and risk factors. For instance, anaemia was frequent in colorectal (9% [HUS]-23% [IMASIS]; 791/8395-730/3141 individuals) and stomach cancers (10% [HUS]-34% [IMASIS]; 130/1277-225/670), while chronic obstructive pulmonary disease (18% [SIDIAP]-34% [HUVM], 5310/29,009-1039/3063) and pneumonia (5% [CPRD GOLD]-33% [UTARTU], 1904/34,990-1001/3063) were common in lung cancer patients. Breast and prostate cancers had the highest one, five and ten-year overall survival, with 5-year OS ranging from 76% [ECi]-85% [IMASIS] and 75% [HUVM]-83% [SIDIAP], respectively. Pancreatic cancer showed the lowest survival ranging from 3% [NCR]-25% [IMASIS] 5-year OS. Variations in cancer survival estimates were observed across data sources and countries. Interpretation: Federated analysis of diverse European real-world databases, standardised to OMOP-CDM, offer a valuable benchmark for future cancer research, particularly in understanding prodromes and risk factors, often recorded in routinely collected healthcare data prior to cancer onset. Funding: The European Health Data & Evidence Network has received funding from the Innovative Medicines Initiative 2 Joint Undertaking (JU) under grant agreement No 806968. The JU receives support from the European Union's Horizon 2020 research and innovation programme and the European Federation of Pharmaceutical Industries and Associations partners.
Authors: Irene López-Sánchez, Anna Palomar-Cros, Ravinder Claire, Laura Pérez-Crespo, Agustina Giuliodori, Ian Koblbauer, Jeremy Dietz, Jamie Elvidge, James Koh, Asieh Golozar, Juan Manuel Ramirez-Anguita, Angela Leis, Miguel-Angel Mayer, Nicola Symmers, Mahéva Vallet, Colin McLean, Peter S. Hall, Mees Mosseveld, Katia Verhamme, Espen Enerly, Peter Prinsen, Jelle Evers, Marek Oja, Raivo Kolde, Rafael Marcos-Gragera, Eric Fey, Kimmo Porkka, Tiago Taveira-Gomes, Fernanda Estevinho, Alberto Moreno Conde, Jesus Moreno Conde, Carlos Miguez Sanchez, Evelyne Fournier, Andrea Pistillo, Xihang Chen, George Corby, Abigail Robinson, Maria T. Sanchez-Santos, Antonella Delmestri, Wai Yi Man, Martí Català, Marta Alcalde-Herraiz, Edward Burn, Daniel Prieto-Alhambra, Talita Duarte-Salles, Danielle Newby
Institutions: Universitat Autònoma de Barcelona, Institut Universitari d'Investigació en Atenció Primària Jordi Gol, National Institute for Health and Care Excellence, University of Oxford, Hospital del Mar Research Institute, Hospital Del Mar, Western General Hospital, Edinburgh Cancer Research, Institute of Genetics and Cancer, University of Edinburgh, Erasmus MC, Norwegian Institute of Public Health, Cancer Registry of Norway, Netherlands Comprehensive Cancer Organisation, University of Tartu, Universitat de Girona, Josep Carreras Leukaemia Research Institute, Institut Català d'Oncologia, Institut d'Investigació Biomèdica de Girona, Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública, University of Helsinki, Helsinki University Hospital, Hospital District of Helsinki and Uusimaa, Fernando Pessoa University, Universidade do Porto, Unidade Local de Saúde de Matosinhos, Consejo Superior de Investigaciones Científicas, Hospital Universitario Virgen Macarena, Instituto de Biomedicina de Sevilla, Universidad de Sevilla, University of Geneva
Language: English
Subfield: Oncology
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $4,930
Funders: Univerzita Karlova v Praze, National Institute for Health and Care Excellence, European Federation of Pharmaceutical Industries and Associations, Innovative Health Initiative, European Commission, Universitat de Barcelona, Innovative Medicines Initiative, Universitat Autònoma de Barcelona, Sjællands Universitetshospital, Horizon 2020 Framework Programme, lékařská fakulta Univerzity Karlovy, Norwegian Institute of Public Health, HORIZON EUROPE European Innovation Council
OpenAlex ID: W7125395656