Analysis of Competing Risks of Causes of Death in Cancer Patients from Golestan, Iran over Twelve Years (2004-2016)

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Abstract

Background:

Cancer-related causes of death (cancer CoD) are the main etiologies of death in cancer patients. Recent increase in survival rates of cancer patients resulted in higher risk of dying from causes other than cancer, called competing causes of death (competing CoD). We aim to characterize competing CoD among cancer patients in Golestan province, Northern Iran.

Methods:

Data on cancer incidence was obtained from the Golestan population-based cancer registry (GPCR) dataset. Data on causes of death was obtained from the Golestan death registry (GDR) dataset. Using a linkage method between the GPCR and GDR dataset, we prepared the study dataset including data on vital status and causes of death in our cancer patients. The proportions of cancer CoD and competing CoD were calculated. Multivariate logistic regression analysis was considered to assess the relationship between competing CoD and other variables.

Results:

Overall, 4,184 cancer patients died in the study population, including 2,488 men (59.9%). Cause of death in 3,455 cases was cancer and 729 cases (17.4%) died due to competing CoD. Ischemic heart disease (40.7%) was the most common competing CoD in our population. Higher survival rate was the strongest variable related to the competing CoD (adjusted OR=1.91; 95%CI: 1.61-2.26). Residence area, age group and year of death were other indicators of competing CoD in our population.

Conclusion:

Our results suggest high rates of competing CoD in our cancer patients. Competing CoD should be mentioned in cancer control planning both in clinical practice as well as in public health policy making.

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Most cited references 37

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Global Cancer Statistics 2018: GLOBOCAN Estimates of Incidence and Mortality Worldwide for 36 Cancers in 185 Countries

Ahmedin Jemal, Lindsey A Torre, Rebecca Siegel … (2018)

This article provides a status report on the global burden of cancer worldwide using the GLOBOCAN 2018 estimates of cancer incidence and mortality produced by the International Agency for Research on Cancer, with a focus on geographic variability across 20 world regions. There will be an estimated 18.1 million new cancer cases (17.0 million excluding nonmelanoma skin cancer) and 9.6 million cancer deaths (9.5 million excluding nonmelanoma skin cancer) in 2018. In both sexes combined, lung cancer is the most commonly diagnosed cancer (11.6% of the total cases) and the leading cause of cancer death (18.4% of the total cancer deaths), closely followed by female breast cancer (11.6%), prostate cancer (7.1%), and colorectal cancer (6.1%) for incidence and colorectal cancer (9.2%), stomach cancer (8.2%), and liver cancer (8.2%) for mortality. Lung cancer is the most frequent cancer and the leading cause of cancer death among males, followed by prostate and colorectal cancer (for incidence) and liver and stomach cancer (for mortality). Among females, breast cancer is the most commonly diagnosed cancer and the leading cause of cancer death, followed by colorectal and lung cancer (for incidence), and vice versa (for mortality); cervical cancer ranks fourth for both incidence and mortality. The most frequently diagnosed cancer and the leading cause of cancer death, however, substantially vary across countries and within each country depending on the degree of economic development and associated social and life style factors. It is noteworthy that high-quality cancer registry data, the basis for planning and implementing evidence-based cancer control programs, are not available in most low- and middle-income countries. The Global Initiative for Cancer Registry Development is an international partnership that supports better estimation, as well as the collection and use of local data, to prioritize and evaluate national cancer control efforts. CA: A Cancer Journal for Clinicians 2018;0:1-31. © 2018 American Cancer Society.

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A population-based study of cardiovascular disease mortality risk in US cancer patients

Kathleen Sturgeon, Lei Deng, Shirley M Bluethmann … (2019)

This observational study characterized cardiovascular disease (CVD) mortality risk for multiple cancer sites, with respect to the following: (i) continuous calendar year, (ii) age at diagnosis, and (iii) follow-up time after diagnosis. The Surveillance, Epidemiology, and End Results program was used to compare the US general population to 3 234 256 US cancer survivors (1973–2012). Standardized mortality ratios (SMRs) were calculated using coded cause of death from CVDs (heart disease, hypertension, cerebrovascular disease, atherosclerosis, and aortic aneurysm/dissection). Analyses were adjusted by age, race, and sex. Among 28 cancer types, 1 228 328 patients (38.0%) died from cancer and 365 689 patients (11.3%) died from CVDs. Among CVDs, 76.3% of deaths were due to heart disease. In eight cancer sites, CVD mortality risk surpassed index-cancer mortality risk in at least one calendar year. Cardiovascular disease mortality risk was highest in survivors diagnosed at <35 years of age. Further, CVD mortality risk is highest (SMR 3.93, 95% confidence interval 3.89–3.97) within the first year after cancer diagnosis, and CVD mortality risk remains elevated throughout follow-up compared to the general population. The majority of deaths from CVD occur in patients diagnosed with breast, prostate, or bladder cancer. We observed that from the point of cancer diagnosis forward into survivorship cancer patients (all sites) are at elevated risk of dying from CVDs compared to the general US population. In endometrial cancer, the first year after diagnosis poses a very high risk of dying from CVDs, supporting early involvement of cardiologists in such patients.

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Causes of death among cancer patients

NG Zaorsky, TM Churilla, BL Egleston … (2016)

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.

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Author and article information

Journal

Journal ID (nlm-ta): Asian Pac J Cancer Prev

Journal ID (iso-abbrev): Asian Pac J Cancer Prev

Journal ID (publisher-id): APJCP

Title: Asian Pacific Journal of Cancer Prevention : APJCP

Publisher: West Asia Organization for Cancer Prevention (Iran )

ISSN (Print): 1513-7368

ISSN (Electronic): 2476-762X

Publication date (Print): October 2021

Volume: 22

Issue: 10

Pages: 3137-3142

Affiliations

[1 ] Golestan Research Center of Gastroenterology and Hepatology, Golestan University of Medical Sciences, Gorgan, Iran.

[2 ] Omid Cancer Research Center, Omid Preventive Medicine and Heath Promotion Center, Golestan University of Medical Sciences, Gorgan, Iran.

[3 ] Cancer Research Center, Golestan University of Medical Sciences, Gorgan, Iran.

[4 ] Deputy of Public Health, Golestan University of Medical Sciences, Gorgan, Iran.

[5 ] Statistics and Information Technology Office, Golestan University of Medical Sciences, Gorgan, Iran.

[6 ] Death Registry Unit, Deputy of Public Health, Golestan University of Medical Sciences, Gorgan, Iran.

[7 ] Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK.

Author notes

[* ]For Correspondence: roshandel_md@yahoo.com. Mostafa Zare and Susan Hasanpour-Heidari have equal contribution in this study.

Article

DOI: 10.31557/APJCP.2021.22.10.3137

PMC ID: 8858227

PubMed ID: 34710989

SO-VID: cc02f50f-9071-41b8-9b78-f0aa09f1590a

License:

This is an Open Access article distributed under the terms of the Creative Commons Attribution License, ( http://creativecommons.org/licenses/by/3.0/) which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

History

Date received : 16 February 2021

Date accepted : 18 October 2021

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Analysis of Competing Risks of Causes of Death in Cancer Patients from Golestan, Iran over Twelve Years (2004-2016)

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Abstract

Background:

Methods:

Results:

Conclusion:

Related collections

Cancer Metabolism

Most cited references 37

Global Cancer Statistics 2018: GLOBOCAN Estimates of Incidence and Mortality Worldwide for 36 Cancers in 185 Countries

A population-based study of cardiovascular disease mortality risk in US cancer patients

Causes of death among cancer patients

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