Need for nursing care support in cancer patients: Registry-linkage study in Germany

Jacob Spallek, Jürgen Breckenkamp, Klaus Kraywinkel, Wolfgang Schwabe, Volker Krieg, Wolfgang Greiner, Oliver Damm, Oliver Razum


Aim: In Germany, very little is known about the need for assistance and nursing care support among cancer patients after hospitalization. The aim of this study was to describe nursing care support for cancer patients and to analyse whether these patients need more care assistance than other persons in need for care.

Methods: This was a registry linkage study conducted in 2011. Cases were identified from the population-based cancer registry for the Muenster District in north-western Germany and in factually anonymised form linked by a semi-automatic probabilistic procedure (the standard procedure of the cancer registry) with medical examination records of patients applying for assistance and nursing care support from the regional statutory health insurance. The application records of 4,029 patients with colon, breast and prostate cancer were compared to a reference group of 13,104 non-cancer patients.

Results: In only 41.7% of colon, 45.8% of breast and 37.4% of prostate cancer patients was the malignancy the main underlying diagnostic cause for the application of assistance and nursing care. These patients were on average younger (mean age 71.1 vs. 76.8 years) than the non-cancer reference group, required higher levels of support (79.5 vs. 58.1% “considerable” or higher level care need) and their applications were less likely to be rejected (odds ratios [ORs] 0.26, 0.28, and 0.31, respectively). By contrast, the proportion of successful applications and the level of support granted did not differ between multimorbid cancer patients with other main diagnoses as compared to non-cancer applicants.

Conclusion: Patients with colon, breast or prostate cancer do not need per se more nursing care than non-cancer patients. Only if cancer is the main underlying diagnosis for nursing care support, higher levels of support are needed.



cancer patients, Germany, nursing care.

Full Text:


Cite this article


Brenner H. Long-term survival rates of cancer patients achieved by the end of the 20th century: a period analysis. Lancet 2002;360:1131-5.

Cockle-Hearne J, Charnay-Sonnek F, Denis L, Fairbanks HE, Kelly D, Kav S, et al. The impact of supportive nursing care on the needs of men with prostate cancer: a study across seven European countries. Brit J Cancer 2013;109:2121-30.

Magnuson A, Allore H, Cohen HJ, Mohile SG, Williams GR, Chapman A, et al. Geriatric assessment with management in cancer care: Current evidence and potential mechanisms for future research. J Geriatr Oncol 2016;7:242-8.

Guerard EJ, Nightingale G, Bellizzi K, Burhenn P, Rosko A, Artz AS, et al. Survivorship Care for Older Adults with Cancer: U 13 Conference Report. J Geriatr Oncol 2016;7:305-12.

Salz T, Baxi S. Moving survivorship care plans forward: focus on care coordination. Cancer Med 2016;5:1717-22.

Karnakiis T, Gattás-Vernaglia IF, Saraiva MD, Gil-Junior LA, Kanaji AL, Jacob-Filho W. The geriatrician’s perspective on practical aspects of the multidisciplinary care of older adults with cancer. J Geriatr Oncol 2016;7:341-5.

Medizinischer Dienst der Krankenversicherung Westfalen-Lippe. Wirüberuns – Aufgaben und Leistungen. Available from: (accessed: July 30, 2018).

Robert Koch-Institut und die Gesellschaft der epidemiologischen Krebsregister (Eds). Krebs in Deutschland 2005/2006. Häufigkeiten und Trends. Berlin; 2010.

GEKID. Cancer in Germany, incidence and trends. Saarbrücken, GEKID; 2006. Available from: (accessed: July 30, 2018).

EKR Epidemiologisches Krebsregisterfür den RegierungsbezirkMünster (Eds.). Krebserkrankungenim RegierungsbezirkMünster, Band 3. Berichtfür die Jahre 1998 – 2002. Münster, EKR; 2004.

LandeszentrumGesundheit Nordrhein-Westfalen. Indikatoren der Ländergesundheits-Berichterstattung. Indikator 3.49_01, Jahr 2009. Available from: (accessed: July 30, 2018).

Breckenkamp J, Spallek J, Kraywinkel K, Krieg V, Schwabe W, Greiner W, et al. Abgleich von Verwaltungsdaten des Medizinischen Dienstes der Krankenversicherungmit Krebsregisterdaten. Das Gesundheitswesen 2012;74:e52-60.

SGB §15; Sozialgesetzbuch (SGB), Elftes Buch (XI) – SozialePflegeversicherung. Artikel 1 des Gesetzesvom 26. Mai 1994. §15 Stufen der Pflegebedürftigkeit. Available from: (accessed: July 30, 2018).

Kirchberger I, Meisinger C, Heier M, Zimmermann AK, Thorand B, Autenrieth CS, et al. Patterns of multimorbidity in the aged population. Results from the KORA-Age study. PLoS One 2012;7:1.

Fuchs J, Busch M, Lange C, Scheidt-Nave C. Prevalence and patterns of morbidity among adults in Germany. Results of the German telephone health interview survey German Health Update (GEDA) 2009. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 2012;55:576-8.

van den Bussche H, Koller D, Kolonko T, Hansen H, Wegscheider K, Glaeske G, et al. Which chronic diseases and disease combinations are specific to multimorbidity in the elderly? Results of a claims data based cross-sectional study in Germany. BMC Public Health 2011;11:101.

Schäfer I. Does multimorbidity influence the occurrence rates of chronic conditions? A claims data based comparison of expected and observed prevalence rates. PLoS One 2012;7:e45390.

Wagner A, Fleer B. Pflegebericht des Medizinischen Dienstes 2006. Medizinischer Dienst des Spitzenverbandes Bund der Krankenkassene.V. Essen; 2007.

Wagner A, Brucker U. Pflegebericht des Medizinischen Dienstes 2001-2002. MedizinischerDienst des Spitzenverbandes Bund der Krankenkassene.V. Essen; 2003.

Hansen DG, Larsen PV, Holm LV, Rottmann N, Bergholdt SH, Søndergaard J. Association between unmet needs and quality of life of cancer patients: A population-based study. Acta Oncol 2013;52:391-9.

Puts MTE, Papoutsis A, Springall E, Tourangeau AE. A systematic review of unmet needs of newly diagnosed older cancer patients undergoing active cancer treatment. Support Care Canser 2012;20:1377-94.

Maguire R, Papadopoulou C, Kotronoulas G, Simpson MF, McPhelim J, Irvine L. A systematic review of supportive care needs of people living with lung cancer. Eur J Oncol Nurs 2013;17:449-64.

Fennell ML. Nursing homes and cancer care. Health Serv Res 2009;44:6.

Nitsch D, Morton S, De Stavola B, Clark H, Leon DA. How good is probabilistic record linkage to reconstruct reproductive histories? Results from the Aberdeen children of the 1950s study. BMC Med Res Methodol 2006;6:15.

Ronellenfitsch U, Kyobutungi C, Becher H, Razum O. Large-scale, population-based epidemiological studies with record linkage can be done in Germany. Eur J Epidemiol 2004;19:1073-4.

DOI: 10.4119/UNIBI/SEEJPH-2018-204

Copyright (c) 2018 Jacob Spallek, Jürgen Breckenkamp, Klaus Kraywinkel, Wolfgang Schwabe, Volker Krieg, Wolfgang Greiner, Oliver Damm, Oliver Razum

Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 International License.