中年癌症患者非癌症死亡的风险分类

Risk classification for non-cancer death in middle-aged cancer patients.

作者信息

Guan Tianwang, Jiang Yanting, Tu Peinan, Ye Baokui, Zeng Liangjia, Luo Zehao, Chi Kaiyi, Liang Haowen, Yang Yuting, Huang Jinqi, Zhang Binghua, Tai Rundong, Ye Jujian, Deng Zhilin, Ke Yushen, Chen Huiwan, Zhang Zhiling, Liu Zhigang, Ou Caiwen

机构信息

Dongguan Key Laboratory of Precision Diagnosis and Treatment for Tumors, Dongguan Engineering Research Center for Innovative Boron Drugs and Novel Radioimmune Drugs, Cancer Center, the 10th Affiliated Hospital of Southern Medical University, Southern Medical University, Guangzhou 510280, China; Guangdong Engineering Research Center of Boron Neutron Therapy and Application in Malignant Tumors, Dongguan 523059, China; Guangdong Provincial Key Laboratory of Cardiac Function and Microcirculation, Guangzhou 510280, China.

Department of Radiation Oncology, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou 310003, Zhejiang, China.

出版信息

J Adv Res. 2024 Dec 25. doi: 10.1016/j.jare.2024.12.039.

DOI:10.1016/j.jare.2024.12.039

PMID:39730025

Abstract

INTRODUCTION

Non-cancer events are important causes of competing mortality among cancer patients. However, the risk of non-cancer death and risk classification in middle-aged cancer patients is not clear. To comprehensively analyze the risk of non-cancer deaths in 24 different cancers among middle-aged patients.

METHODS

Standardized mortality rate (SMR), absolute excess risk (AER), proportion of deaths, age-adjusted mortality rate (AAMR), and the competing model were used to assess the risk of non-cancer death in middle-aged cancer patients. A non-cancer death risk classification was developed for the 24 cancer types based on the competing risk of non-cancer death and the risk of non-cancer death (hazard ratio).

RESULTS

A total of 1,082,030 middle-aged cancer patients of 24 cancer types was identified. The risk of non-cancer death was elevated in middle-aged cancer patients compared to the general middle-aged population (SMR = 3.37, 95 % CI 3.35-3.39, AER = 99.18). The cumulative mortality was higher for non-cancer causes compared to primary cancer in 15 cancer types. The AAMR for non-cancer causes declined from 2.3 % in 1975 to 1.4 % in 2017. A risk classification was developed to classify different cancers into 6 risk categories.

CONCLUSION

The risk of non-cancer death was elevated in middle-aged cancer patients and varied for different cancer types. A new risk classification system was developed to estimate the risk of non-cancer deaths in different cancers, and the 24 cancer types were classified into 6 distinct categories. These results highlight the necessity for risk stratification management for non-cancer death in middle-aged cancer patients.

摘要

引言

非癌症事件是癌症患者竞争性死亡的重要原因。然而，中年癌症患者的非癌症死亡风险及风险分类尚不清楚。为全面分析中年患者中24种不同癌症的非癌症死亡风险。

方法

采用标准化死亡率（SMR）、绝对超额风险（AER）、死亡比例、年龄调整死亡率（AAMR）和竞争模型来评估中年癌症患者的非癌症死亡风险。基于非癌症死亡的竞争风险和非癌症死亡风险（风险比），为24种癌症类型制定了非癌症死亡风险分类。

结果

共确定了24种癌症类型的1,082,030名中年癌症患者。与一般中年人群相比，中年癌症患者的非癌症死亡风险升高（SMR = 3.37，95%CI 3.35 - 3.39，AER = 99.18）。在15种癌症类型中，非癌症原因导致的累积死亡率高于原发性癌症。非癌症原因的AAMR从1975年的2.3%降至2017年的1.4%。制定了一种风险分类，将不同癌症分为6个风险类别。