SynthesisBMJ open2026
Association between comorbidities and differences in treatment decisions and outcomes in patients with colon or rectal cancer: a systematic review.
Synthesis in BMJ open, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
0 citing papers in PubMed.
No citing paper in PubMed yet.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
5 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesTo systematically evaluate associations between comorbidities and differences in treatment decisions, outcomes, health-related quality of life (HRQoL), healthcare resource utilisation and costs, in patients with colon or rectal cancer.
designSystematic review. DATA SOURCES: PubMed (Medline) and Embase databases were searched for studies published from January 2000 until January 2024. ELIGIBILITY CRITERIA FOR SELECTING STUDIES: We included articles that compared the presence and absence of comorbidities, evaluated multiple comorbid conditions or used the Charlson Comorbidity Index, or variations such as the Charlson-Deyo Index. Primary and secondary outcome measures included cancer treatments, outcomes (including complications from treatments, survival and mortality rates), HRQoL, healthcare resource use and costs. DATA EXTRACTION AND SYNTHESIS: Two independent reviewers used standardised methods to search, screen and code included studies. Risk of bias was assessed using the Joanna Briggs Institute checklists to ensure the quality of data. Findings were summarised narratively.
resultsAfter duplicates were removed, 15 394 hits were screened and 31 studies were selected for inclusion in this systematic review. Comorbidities were associated with a lower likelihood of receiving treatment and lower survival rates and HRQoL, alongside a higher likelihood of complications following treatment, higher mortality rates and higher healthcare resource use. There were very limited studies that reported on HRQoL and resource use, and none reporting data directly relating to the impact of comorbidities on costs. These results were consistent across North America, Europe, Australia and New Zealand.
conclusionsFor patients with colon and rectal cancer, comorbidities are associated with a lower likelihood of receiving treatments and poorer health outcomes. With global populations ageing, there is likely to be an increase in patients with colon and rectal cancer with comorbidities. Therefore, further research is necessary, especially to inform decisions regarding patient management and treatment, and to understand the implications on healthcare resource allocation, costs and HRQoL.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.