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Non-cancer mortality among long-term survivors of adult cancer in Korea: national cancer registry study

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Abstract

Objectives

To investigate the pattern of non-cancer deaths and to determine whether there is excess mortality from non-cancer causes among Korean long-term survivors of adult cancer.

Methods

We merged national cancer registry data and national death registration data to determine non-cancer death patterns of 243,713 people who were diagnosed with cancer from 1993 to 2000 and who survived ≥5 years. We calculated standardized mortality ratios (SMRs) by an indirect standardization method.

Results

Of the patient population, 26,498 (10.9%) had died as of December 2005; the cause of death for 6,364 (24.0%) of those was not cancer. The proportion of non-cancer mortality increased with age at diagnosis and correlated with the 5-year survival rate (r = 0.336 for women, 0.571 for men). Although the risk for non-cancer death was lower among long-term survivors in general (SMR, 0.78; 95% CI, 0.76–0.80), it was higher among younger survivors (SMR, 1.23–2.50, for those who died before 50) than the general population. Survivors had an elevated suicide rate (SMR, 1.28; 95% CI, 1.15–1.42), especially male (SMR, 1.35; 95% CI, 1.19–1.53) and stomach cancer survivors (SMR, 1.38; 95% CI, 1.14–1.66).

Conclusions

Appropriate medical attention for long-term adult cancer survivors, especially younger survivors, is warranted to prevent premature deaths from non-cancer causes.

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References

  1. Ries LAG, Melbert D, Krapcho M, Stinchcomb DG, Howlader N, Horner MJ, Mariotto A, Miller BA, Feuer EJ, Altekruse SF, Lewis DR, Clegg L, Eisner MP, Reichman M, Edwards BK (eds) (2007) SEER cancer statistics review, National Cancer Institute, Bethesda, MD, 1975–2005, http://seer.cancer.gov/csr/1975_2005/, based on November 2007 SEER data submission, posted to the SEER web site, 2008

  2. Micheli A, Mugno E, Krogh V, Quinn MJ, Coleman M, Hakulinen T et al (2002) Cancer prevalence in European registry areas. Ann Oncol 13(6):840–865

    Article  CAS  PubMed  Google Scholar 

  3. NCC (2008) Cancer facts and figures. National Cancer Center, Goyang

    Google Scholar 

  4. Carver JR, Shapiro CL, Ng A, Jacobs L, Schwartz C, Virgo KS et al (2007) American society of clinical oncology clinical evidence review on the ongoing care of adult cancer survivors: cardiac and pulmonary late effects. J Clin Oncol 25(25):3991–4008

    Article  CAS  PubMed  Google Scholar 

  5. Stein KD, Syrjala KL, Andrykowski MA (2008) Physical and psychological long-term and late effects of cancer. Cancer 112(11 Suppl):2577–2592

    Article  PubMed  Google Scholar 

  6. Shin DW, Nam JH, Kwon YC, Park SY, Bae DS, Park CT et al (2008) Comorbidity in disease-free survivors of cervical cancer compared with the general female population. Oncology 74(3–4):207–215

    Article  PubMed  Google Scholar 

  7. Lawless SC, Verma P, Green DM, Mahoney MC (2007) Mortality experiences among 15 + year survivors of childhood and adolescent cancers. Pediatr Blood Cancer 48(3):333–338

    Article  PubMed  Google Scholar 

  8. Bluhm EC, Ronckers C, Hayashi RJ, Neglia JP, Mertens AC, Stovall M et al (2008) Cause-specific mortality and second cancer incidence after non-Hodgkin lymphoma: a report from the childhood cancer survivor study. Blood 111(8):4014–4021

    Article  CAS  PubMed  Google Scholar 

  9. Mertens AC, Yasui Y, Neglia JP, Potter JD, Nesbit ME Jr, Ruccione K et al (2001) Late mortality experience in five-year survivors of childhood and adolescent cancer: the childhood cancer survivor study. J Clin Oncol 19(13):3163–3172

    CAS  PubMed  Google Scholar 

  10. Brenner H, Arndt V (2005) Long-term survival rates of patients with prostate cancer in the prostate-specific antigen screening era: population-based estimates for the year 2000 by period analysis. J Clin Oncol 23(3):441–447

    Article  PubMed  Google Scholar 

  11. Ketchandji M, Kuo YF, Shahinian VB, Goodwin JS (2009) Cause of death in older men after the diagnosis of prostate cancer. J Am Geriatr Soc 57(1):24–30

    Article  PubMed  Google Scholar 

  12. Fouad MN, Mayo CP, Funkhouser EM, Irene Hall H, Urban DA, Kiefe CI (2004) Comorbidity independently predicted death in older prostate cancer patients, more of whom died with than from their disease. J Clin Epidemiol 57(7):721–729

    Article  PubMed  Google Scholar 

  13. Merrick GS, Butler WM, Wallner KE, Galbreath RW, Allen ZA, Adamovich E (2006) Androgen-deprivation therapy does not impact cause-specific or overall survival after permanent prostate brachytherapy. Int J Radiat Oncol Biol Phys 65(3):669–677

    PubMed  Google Scholar 

  14. Bittner N, Merrick GS, Galbreath RW, Butler WM, Wallner KE, Allen ZA et al (2008) Primary causes of death after permanent prostate brachytherapy. Int J Radiat Oncol Biol Phys 72(2):433–440

    PubMed  Google Scholar 

  15. Lu-Yao G, Stukel TA, Yao SL (2004) Changing patterns in competing causes of death in men with prostate cancer: a population based study. J Urol 171(6 Pt 1):2285–2290

    Article  PubMed  Google Scholar 

  16. Fossa SD, Gilbert E, Dores GM, Chen J, McGlynn KA, Schonfeld S et al (2007) Noncancer causes of death in survivors of testicular cancer. J Natl Cancer Inst 99(7):533–544

    Article  PubMed  Google Scholar 

  17. Hooning MJ, Aleman BM, van Rosmalen AJ, Kuenen MA, Klijn JG, van Leeuwen FE (2006) Cause-specific mortality in long-term survivors of breast cancer: a 25-year follow-up study. Int J Radiat Oncol Biol Phys 64(4):1081–1091

    PubMed  Google Scholar 

  18. Guadagnolo BA, Zagars GK, Ballo MT, Strom SS, Pollock RE, Benjamin RS (2008) Mortality after cure of soft-tissue sarcoma treated with conservation surgery and radiotherapy. Cancer 113:411–418

    Article  PubMed  Google Scholar 

  19. Baade PD, Fritschi L, Eakin EG (2006) Non-cancer mortality among people diagnosed with cancer (Australia). Cancer Causes Control 17(3):287–297

    Article  PubMed  Google Scholar 

  20. Brown BW, Brauner C, Minnotte MC (1993) Noncancer deaths in white adult cancer patients. J Natl Cancer Inst 85(12):979–987

    Article  CAS  PubMed  Google Scholar 

  21. Simonelli C, Annunziata MA, Chimienti E, Berretta M, Tirelli U (2008) Cancer survivorship: a challenge for the European oncologists. Ann Oncol 19:1216–1217

    Article  CAS  PubMed  Google Scholar 

  22. Simonelli C, Berretta M, Tirelli U, Annunziata MA (2008) Clinical management of long-term cancer survivors. J Clin Oncol 26(1):161–2; author reply 162

    Google Scholar 

  23. Yoo KY (2008) Cancer control activities in the Republic of Korea. Jpn J Clin Oncol 38(5):327–333

    Article  PubMed  Google Scholar 

  24. National Cancer Center. National Cancer Registration Program. Goyang, Korea. (www.ncc.re.kr. Accessed 15 Sep 2008)

  25. Parkin DM, Whelan SL, Ferlay J, Teppo L, Thomas DN (2002) Cancer incidence in five continents, Volume VIII. International Agency for Research on Cancer, Lyon

    Google Scholar 

  26. Korea National Statistical Office (2006) Annual report on the cause of death statistics. Daejeon, Korea

  27. Shin HR, Jung KW, Won YJ, Park JG, 139 KCCR-affiliated Hospitals (2004) 2002 Annual report of the Korea central cancer registry: based on registered data from 139 hospitals. Cancer Res Treat 36(2):103–114

    Google Scholar 

  28. Kim SG, Hahm MI, Choi KS, Seung NY, Shin HR, Park EC (2002) The economic burden of cancer in Korea in 2002. Eur J Cancer Care 17(2):136–144

    Article  Google Scholar 

  29. Rothman KJ, Boice JDJ (1979) Epidemiologic analysis with a programmable calculator (NIH Pub No. 79–1649). National Institutes of Health, Bethesda

    Google Scholar 

  30. OECD (2000) OECD Health Data, 2000. OECD (Organisation for Economic Co-operation and Development), Paris

    Google Scholar 

  31. Sagstuen H, Aass N, Fossa SD, Dahl O, Klepp O, Wist EA et al (2005) Blood pressure and body mass index in long-term survivors of testicular cancer. J Clin Oncol 23(22):4980–4990

    Article  CAS  PubMed  Google Scholar 

  32. Oh JH, Baum DD, Pham S, Cox M, Nguyen ST, Ensor J et al (2007) Long-term complications of platinum-based chemotherapy in testicular cancer survivors. Med Oncol 24(2):175–181

    Article  CAS  PubMed  Google Scholar 

  33. Meinardi MT, Gietema JA, van der Graaf WT, van Veldhuisen DJ, Runne MA, Sluiter WJ et al (2000) Cardiovascular morbidity in long-term survivors of metastatic testicular cancer. J Clin Oncol 18(8):1725–1732

    CAS  PubMed  Google Scholar 

  34. Huddart RA, Norman A, Shahidi M, Horwich A, Coward D, Nicholls J et al (2003) Cardiovascular disease as a long-term complication of treatment for testicular cancer. J Clin Oncol 21(8):1513–1523

    Article  CAS  PubMed  Google Scholar 

  35. Keating NL, O’Malley AJ, Smith MR (2006) Diabetes and cardiovascular disease during androgen deprivation therapy for prostate cancer. J Clin Oncol 24(27):4448–4456

    Article  CAS  PubMed  Google Scholar 

  36. Saigal CS, Gore JL, Krupski TL, Hanley J, Schonlau M, Litwin MS (2007) Androgen deprivation therapy increases cardiovascular morbidity in men with prostate cancer. Cancer 110(7):1493–1500

    Article  CAS  PubMed  Google Scholar 

  37. D’Amico AV, Denham JW, Crook J, Chen MH, Goldhaber SZ, Lamb DS et al (2007) Influence of androgen suppression therapy for prostate cancer on the frequency and timing of fatal myocardial infarctions. J Clin Oncol 25(17):2420–2425

    Article  PubMed  CAS  Google Scholar 

  38. Tsai HK, D’Amico AV, Sadetsky N, Chen MH, Carroll PR (2007) Androgen deprivation therapy for localized prostate cancer and the risk of cardiovascular mortality. J Natl Cancer Inst 99(20):1516–1524

    Article  PubMed  Google Scholar 

  39. Pyun SS, Cho KS, Seo SI, Oh SJ, Chung JS, Lee SE (1997) The change of clinical characteristics of prostatic cancer before and after the introduction of prostate specific antigen assay. Korean J Urol 38(3):270–274

    Google Scholar 

  40. Satariano WA, Ragland KE, Van Den Eeden SK (1998) Cause of death in men diagnosed with prostate carcinoma. Cancer 83(6):1180–1188

    Article  CAS  PubMed  Google Scholar 

  41. Brewster AM, Hortobagyi GN, Broglio KR, Kau SW, Santa-Maria CA, Arun B et al (2008) Residual risk of breast cancer recurrence 5 years after adjuvant therapy. J Natl Cancer Inst 100(16):1179–1183

    Article  PubMed  Google Scholar 

  42. Aus G, Pileblad E, Hugosson J (1995) Impact of competing mortality on the cancer-related mortality in localized prostate cancer. Urology 46(5):672–675

    Article  CAS  PubMed  Google Scholar 

  43. Haupt R, Valsecchi MG, Silvestri D, De Lorenzo P, Napoli S, Masera G et al (2000) Early and late deaths after elective end of therapies for childhood cancer in Italy. Int J Cancer 86(3):393–398

    Article  CAS  PubMed  Google Scholar 

  44. Robertson CM, Hawkins MM, Kingston JE (1994) Late deaths and survival after childhood cancer: implications for cure. Bmj 309(6948):162–166

    CAS  PubMed  Google Scholar 

  45. Park JY, Moon KT, Chae YM, Jung SH (2008) Effect of sociodemographic factors, cancer, psychiatric disorder on suicide: gender and age-specific patterns. J Prev Med Public Health 41(1):51–60

    Article  PubMed  Google Scholar 

  46. Misono S, Weiss NS, Fann JR, Redman M, Yueh B (2008) Incidence of suicide in persons with cancer. J Clin Oncol 26(29):4731–4738

    Article  PubMed  Google Scholar 

  47. Nordin K, Glimelius B (1997) Psychological reactions in newly diagnosed gastrointestinal cancer patients. Acta Oncol 36(8):803–810

    Article  CAS  PubMed  Google Scholar 

  48. Lee MK, Lee KM, Bae JM, Kim S, Kim YW, Ryu KW et al (2008) Employment status and work-related difficulties in stomach cancer survivors compared with the general population. Br J Cancer 98(4):708–715

    Article  CAS  PubMed  Google Scholar 

  49. Schairer C, Brown LM, Chen BE, Howard R, Lynch CF, Hall P et al (2006) Suicide after breast cancer: an international population-based study of 723, 810 women. J Natl Cancer Inst 98(19):1416–1419

    Article  PubMed  Google Scholar 

  50. Percy C, Stanek E, Gloeckler L (1981) Accuracy of cancer death certificates and its effect on cancer mortality statistics. Am J Public Health 71(3):242–250

    Article  CAS  PubMed  Google Scholar 

  51. Earle CC, Neville BA (2004) Under use of necessary care among cancer survivors. Cancer 101(8):1712–1719

    Article  PubMed  Google Scholar 

  52. American Society of Clinical Oncology (1996) Status of the medical oncology workforce. J Clin Oncol 14(9):2612–2621

    Google Scholar 

  53. Khan NF, Ward A, Watson E, Austoker J, Rose PW (2008) Long-term survivors of adult cancers and uptake of primary health services: a systematic review. Eur J Cancer 44(2):195–204

    Article  PubMed  Google Scholar 

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Acknowledgments

This work was supported by National Cancer Center Grant 0710731-2.

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Authors and Affiliations

  1. National Cancer Control Institute (NCCI) and Hospital, National Cancer Center, 323 Ilsanro, Ilsan dong-gu, Goyang-si, Gyeonggi-do, 411-769, Korea

    Dong Wook Shin, Eunmi Ahn, Hyerim Kim, Sohee Park, Young Ae Kim & Young Ho Yun

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  1. Dong Wook Shin
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Correspondence to Young Ho Yun.

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Shin, D.W., Ahn, E., Kim, H. et al. Non-cancer mortality among long-term survivors of adult cancer in Korea: national cancer registry study. Cancer Causes Control 21, 919–929 (2010). https://doi.org/10.1007/s10552-010-9521-x

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  • DOI: https://doi.org/10.1007/s10552-010-9521-x

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