Journal of cancer survivorship : research and practice · 2026
Frailty and risk of common chronic diseases among cancer survivors: a prospective cohort study.
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Li Wenqian, Zhang Zenghui, Lu Can, Xu Yinuo, Han Shaojie, Zhan Yufei, Ge Guo, Wang Ziwen, Lan Xianwu, Zhang Xiaoshen, Lu Hua, Guo Jun
Аннотация
PURPOSE: We examined the impact of baseline frailty on the incidence of diverse chronic diseases among cancer survivors.
METHODS: We analyzed 21,577 cancer survivors (aged 39-70) from the UK Biobank, excluding those with baseline diseases of interest. Baseline frailty was assessed using the frailty phenotype (range, 0-5) and the frailty index (range, 0-1). Incident cases across 39 chronic diseases were identified via hospital and death records. Cox proportional hazards models were used to estimate hazard ratios (HRs) and 95% CIs.
RESULTS: Frailty was significantly associated with an increased risk of multiple chronic diseases among cancer survivors, with the most pronounced overall effect observed for mental and neurological disorders. Overall, frailty increased the incidence of 28 out of 39 chronic diseases, encompassing all 8 cardiometabolic diseases, 5 of 10 mental/neurological diseases, 5 of 6 digestive system diseases, and 10 of 15 other conditions. Within these categories, the frailty index showed the greatest impact on heart failure (HR, 1.48 [1.36-1.61]); depression (HR, 2.39 [2.19-2.62]); irritable bowel syndrome (HR, 1.79 [1.54-2.08]); and bronchiectasis (HR, 2.11 [1.84-2.41]). Stratified analyses revealed that the association between frailty and risk of anxiety and depression was stronger in cancer survivors aged < 60 years, while prostate cancer survivors exhibited a significantly higher risk for bronchiectasis and diverticular disease. Sensitivity analyses confirmed the stability of the results.
CONCLUSION: Frailty was prospectively associated with an increased risk of diverse chronic diseases in cancer survivors.
IMPLICATIONS FOR CANCER SURVIVORS: Routine assessment of frailty may help identify survivors who need targeted interventions and proactive clinical monitoring to prevent long-term comorbidities and enhance quality of life.
METHODS: We analyzed 21,577 cancer survivors (aged 39-70) from the UK Biobank, excluding those with baseline diseases of interest. Baseline frailty was assessed using the frailty phenotype (range, 0-5) and the frailty index (range, 0-1). Incident cases across 39 chronic diseases were identified via hospital and death records. Cox proportional hazards models were used to estimate hazard ratios (HRs) and 95% CIs.
RESULTS: Frailty was significantly associated with an increased risk of multiple chronic diseases among cancer survivors, with the most pronounced overall effect observed for mental and neurological disorders. Overall, frailty increased the incidence of 28 out of 39 chronic diseases, encompassing all 8 cardiometabolic diseases, 5 of 10 mental/neurological diseases, 5 of 6 digestive system diseases, and 10 of 15 other conditions. Within these categories, the frailty index showed the greatest impact on heart failure (HR, 1.48 [1.36-1.61]); depression (HR, 2.39 [2.19-2.62]); irritable bowel syndrome (HR, 1.79 [1.54-2.08]); and bronchiectasis (HR, 2.11 [1.84-2.41]). Stratified analyses revealed that the association between frailty and risk of anxiety and depression was stronger in cancer survivors aged < 60 years, while prostate cancer survivors exhibited a significantly higher risk for bronchiectasis and diverticular disease. Sensitivity analyses confirmed the stability of the results.
CONCLUSION: Frailty was prospectively associated with an increased risk of diverse chronic diseases in cancer survivors.
IMPLICATIONS FOR CANCER SURVIVORS: Routine assessment of frailty may help identify survivors who need targeted interventions and proactive clinical monitoring to prevent long-term comorbidities and enhance quality of life.