- Immediate risk of non-cancer deaths after a cancer diagnosis. - Background: Receiving a cancer diagnosis may trigger immediate fatal non-cancer health outcomes in addition to dying of cancer itself. - We aim to investigate the full pattern of non-cancer deaths in patients within a year of a cancer diagnosis.. - Standardized mortality ratios (SMRs) were calculated to characterize the relative risks of non-cancer deaths compared with the general population.. - Results: Among 7,366,229 patients, 241,575 non-cancer deaths (15.9%) were recorded in the first year following a cancer diagnosis. - The relative risk of non-cancer deaths was 2.34-fold (95% confidence interval (CI that of the general population. - The majority of non-cancer deaths were caused by cardiovascular diseases (21.8. - Significant elevations in mortality risks were observed for nearly all non- cancer causes, particularly in infectious diseases (SMR: 5.08. - 95% CI were at the highest risk of early non-cancer deaths. - The risks of non-cancer deaths were highest within the first month after diagnosis, and decreased rapidly thereafter.. - Conclusions: Risks of non-cancer deaths vary by the types of causes and anatomic sites of cancer. - Keywords: Cancer diagnosis, Non-cancer deaths, Comorbidity, SEER program, Standardized mortality ratios (SMRs). - As recent progress in cancer prevention, diagnosis, and treatment has prolonged survival of patients with cancer, risk of non-cancer deaths is now becoming a great threat to the health of cancer survivors [1]. - However, risks of deaths from other non-cancer causes remain unclear.. - This study intended to comprehensively assess all the non-cancer causes of death within the first year im- mediately after a cancer diagnosis. - It also aimed to identify the subgroups at particular risk of early death from non-cancer causes.. - Non-cancer deaths occur- ring in the first year after a cancer diagnosis were chosen as the events of interest. - Non-cancer deaths (deaths from any medical cause other than cancer) were defined based on SEER cause-of-death classification variables obtained from the death certificates, and were categorized into 26 major groups [7]. - Although deaths from benign, or un- known behavior neoplasms were also classified as non- cancer deaths by the SEER program, these deaths were not considered as non-cancer deaths during our analyses.. - The remaining 25 major types of non-cancer cause were included in our analysis.. - The mortality rates for non-cancer causes were calcu- lated as the number of non-cancer deaths that occurred within 1 year of diagnosis, divided by person-years of follow-up. - The standardized mortality ratios (SMRs) and corresponding 95% confidence intervals (CIs) of non- cancer deaths were calculated according to previously published methods [9–12]. - The SMRs were estimated as the ratios of observed to expected number of non- cancer deaths within the year following a cancer diagno- sis. - During follow-up deaths were recorded in the first year after diagnosis, of which 241,575 were due to non-cancer causes. - Compared with the general population, the relative risk of non-cancer deaths in patients with a cancer diagnosis was 2.34 (95% CI within the first year after diagno- sis. - Most deaths from non-cancer causes occurring within the first year were observed in patients who were 60 years or older (83.5. - Compared with the general population, non-cancer death risks within the first year after diagnosis were higher among those with an age of 20 to 39 years (SMR: 19.88. - The mortality from non-cancer causes was higher within the first year (SMR: 2.34. - Mortality for major types of non-cancer causes. - On cause-specific analysis, the first leading non- cancer cause of death was CVD (21.8. - 95% CI in the first year after diagnosis (Table 2).. - Anatomic sites associated with higher risks of non-cancer deaths. - Of the different cancer sites, lung cancer was respon- sible for the highest number of non-cancer deaths (17.7. - 95% CI were at the highest risk of early non-cancer deaths, followed by brain (SMR: 5.51. - Trends in SMR of non-cancer deaths based on time following diagnosis. - The trends of SMR for non-cancer deaths during follow- up after diagnosis were determined in this cohort (Fig. - Similar trends were ob- served in all major non-cancer causes (Fig. - In site- Table 2 Risk of non-cancer deaths for the 25 major types of non-cancer causes within the first year after diagnosis among cancer patients. - Other non-cancer causes of death . - Anatomic site-specific analysis for the major types of non-cancer causes of death. - For the major types of non-cancer deaths, the site- specific analyses are presented in Fig. - Table 3 Risk of non-cancer deaths within the first years after diagnosis among patients with cancer by anatomic site. - 2 Risk of deaths from major non-cancer causes by time from diagnosis. - In our population-based cohort study including more than 7 million patients with cancer, the risk of non- cancer deaths was particularly increased within the first year after diagnosis. - The majority of non- cancer deaths were caused by CVD, infectious diseases, and respiratory diseases. - Patients with liver, brain, and lung cancer are most likely to die of non- cancer causes in the first year. - The risk of non-cancer deaths was highest in the period immediately following a cancer diagnosis and decreased rapidly.. - The majority of non-cancer causes of death within the first year may be largely classified into two groups:. - We noted an increase in the risk of death from respiratory diseases (mainly chronic obstructive pulmonary disease [COPD]) in patients with lung cancers. - In addition, the risk of deaths from gastrointestinal and liver diseases was high- est in the diseases of the digestive organs, including the liver, pancreas, stomach and esophagus (Fig. - 3 Risk of non-cancer deaths within the first year after diagnosis by anatomic site and time from diagnosis. - 4 Risk of deaths from major non-cancer causes within the first year after diagnosis by anatomic site. - Following accumulation of all non-cancer causes, the risk of non-cancer deaths was highest in pa- tients with liver cancers. - Additionally, liver cancer and the non- cancer co-morbidities share certain potential risk factors (modifiable and non-modifiable). - Among the different types of cancer, lung cancer was responsible for the highest number of non-cancer deaths, and also had a significantly elevated SMR. - In this study, we found that lung cancer was also a leading cause of death in- volving non-cancer comorbidities in the first year follow- ing diagnosis. - such as age and smoking, are also strongly associated with non-cancer comorbidities, including diseases of the cardiovascular, pulmonary and other systems [36].. - First, the causes of death may have been potentially misclassi- fied due to inaccurate coding in the death certificates [39]. - However, previous studies have shown that for sev- eral non-cancer causes of death, including coronary heart disease [40] and suicide [41, 42], the cause of death codes obtained from death certificates are reasonably valid (sensitivity and specificity >. - this precluded the ana- lysis of non-cancer mortality based on receipt of specific chemotherapy drugs and/or doses of chemotherapy or radiotherapy.. - Finally, personal information on family history or gen- etics was not available in the SEER database, thus our analysis could not provide insight on the role of heredity in risk of non-cancer deaths.. - Risks from non-cancer deaths significantly increase in the first year following a cancer diagnosis in comparison with the general population, particularly in the first month. - Risks of non-cancer deaths vary by the types of causes and anatomic sites of cancer. - The authors acknowledge the efforts of the National Cancer Institute and the Surveillance, Epidemiology, and End Results (SEER) Program tumor registries in the creation of the SEER database.. - The datasets generated and analyzed during the current study are available in the SEER repository (https://seer.cancer.gov/seerstat/).. - https://doi.org/10.1093/annonc/mdw604.. - https://doi.org/10.1056/NEJMoa1110307.. - https://doi.org/10.1002/cncr.31876.. - https://doi.org/10.1002/cncr.32063.. - https://doi.org/10.12 00/JCO . - Incidence of death from unintentional injury among patients with Cancer in the United States.. - https://doi.org/10.1001/jama networkopen . - https://doi.org/10.1093/. - https://doi.org/10.1038/nm1008-1023.. - https://doi.org/1 0.1016/S . - https://doi.org . - https://doi.org/10.2147/TCRM.S68450.. - Fatal infections among Cancer patients: a population-based study in the United States. - https://doi.org/10.1007/s . - https://doi.org/10.1016/j.semcancer . - https://doi.org/10.1016/j.. - https://doi.org/10.1 098/rstb.2016.0274.. - https://doi.org/10.1053/j.seminhematol . - The epidemic of non-Hodgkin lymphoma in the United States: disentangling the effect of HIV, 1992-2009. - doi.org EPI-13-0040.. - HIV trends in the United States: diagnoses and estimated incidence. - https://doi.org/10.2196/publichealth.7051.. - https://doi.org/10.6004/jnccn.2016.0093.. - https://doi.org/1 0.22088/cjim.8.3.153.. - https://doi.org/10.3322/caac.21492.. - https://doi.org/10.1016/j.suronc . - https://doi.org/10.1016/S . - https://doi.org/10.1001/jama.290.7.898.. - doi.org/10.1016/j.metabol . - https://doi.org/10.5603/PiAP.2016.0022.. - doi.org/10.1081/JDI-100100888.. - https://doi.org/10.1016/j.currproblcancer . - https://doi.. - https://doi.org/10.1007/BF00200761.. - https://doi.org/10.1 016/j.currproblcancer
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