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2017 ; 28
(2
): 400-407
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Causes of death among cancer patients
#MMPMID27831506
Zaorsky NG
; Churilla TM
; Egleston BL
; Fisher SG
; Ridge JA
; Horwitz EM
; Meyer JE
Ann Oncol
2017[Feb]; 28
(2
): 400-407
PMID27831506
show ga
BACKGROUND: The purpose of our study was to characterize the causes of death
among cancer patients as a function of objectives: (i) calendar year, (ii)
patient age, and (iii) time after diagnosis. PATIENTS AND METHODS: US death
certificate data in Surveillance, Epidemiology, and End Results Stat 8.2.1 were
used to categorize cancer patient death as being due to index-cancer,
nonindex-cancer, and noncancer cause from 1973 to 2012. In addition, data were
characterized with standardized mortality ratios (SMRs), which provide the
relative risk of death compared with all persons. RESULTS: The greatest relative
decrease in index-cancer death (generally from?>?60% to?30%) was among those
with cancers of the testis, kidney, bladder, endometrium, breast, cervix,
prostate, ovary, anus, colorectum, melanoma, and lymphoma. Index-cancer deaths
were stable (typically?>40%) among patients with cancers of the liver, pancreas,
esophagus, and lung, and brain. Noncancer causes of death were highest in
patients with cancers of the colorectum, bladder, kidney, endometrium, breast,
prostate, testis;?>40% of deaths from heart disease. The highest SMRs were from
nonbacterial infections, particularly among?<50-year olds (e.g. SMR?>1,000 for
lymphomas, P?0.001). The highest SMRs were typically within the first year
after cancer diagnosis (SMRs 10-10,000, P?0.001). Prostate cancer patients had
increasing SMRs from Alzheimer's disease, as did testicular patients from
suicide. CONCLUSION: The risk of death from index- and nonindex-cancers varies
widely among primary sites. Risk of noncancer deaths now surpasses that of cancer
deaths, particularly for young patients in the year after diagnosis.