Journal
CANCER MEDICINE
Volume 10, Issue 8, Pages 2740-2751Publisher
WILEY
DOI: 10.1002/cam4.3673
Keywords
age at diagnosis; colorectal cancer; cumulative incidence; follow‐ up time; non‐ cancer death; SMR
Categories
Funding
- China Scholarship Council [201908080127]
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The study revealed a significant decrease in death from the original diagnosis among CRC patients over time, along with an increase in non-cancer death causes. The most common non-cancer death cause for elderly patients was heart disease, while younger CRC patients tended to die from accidents and adverse effects. The findings also showed changes in specific causes of non-cancer deaths over follow-up time and patient age, suggesting the importance of modifying preventive measures and clinical management for CRC patients.
Background Colorectal cancer (CRC) treatment and patient survival improved greatly. Consequently an increased incidence of non-cancer-related deaths is observed. This study analyzed the causes of non-cancer death for people suffering from CRC based on the year of diagnosis, follow-up time, and patient's age. Methods The data from patients diagnosed with CRC in the years 2000-2016 were taken from the Surveillance, Epidemiology, and End Results 18 database. Patients were categorized according to: death from CRC, non-CRC cancer, and non-cancer. Constituent ratios and standardized mortality ratios (SMRs) were calculated to describe the death causes distribution and relative death risks. Results Between 2000 and 2016, a stable and rapid drop for the original diagnosis as death cause for CRC patients was observed (70.19% to 49.35%). This was coupled to an increase in non-cancer-associated death reasons (23.38% to 40.00%). The most common non-cancer death cause was heart disease, especially for elderly patients. However, deaths from accidents and adverse effects were frequent in younger CRC patients. Patients died from septicemia more often within the first follow-up year; however, a 6-fold increase in death from Alzheimer's disease was found for after at least 180 months follow-up time. The SMRs of all 25 non-cancer death causes initially decreased in all CRC subgroups, followed by an increase with follow-up times. Gradually decreasing SMR values were observed with increasing age of CRC patients. Conclusions These findings could help modify and sharpen preventive measures and clinical management and raise physician's awareness to potential non-CRC death risk factors for CRC patients.
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