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Infective endocarditis and cancer in the elderly

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Abstract

Little is known about the magnitude of the association between infective endocarditis and cancer, and about the natural history of cancer patients with concomitant diagnosis of infective endocarditis. We used the SEER-Medicare linked database to identify individuals aged 65 years or more diagnosed with colorectal, lung, breast, or prostate cancer, and without any cancer diagnosis (5 % random Medicare sample from SEER areas) between 1992 and 2009. We identified infective endocarditis from the ICD-9 diagnosis of each admission recorded in the Medpar file and its incidence rate 90 days around cancer diagnosis. We also estimated the overall survival and CRC-specific survival after a concomitant diagnosis of infective endocarditis. The peri-diagnostic incidence of infective endocarditis was 19.8 cases per 100,000 person-months for CRC, 5.7 cases per 100,000 person-months for lung cancer, 1.9 cases per 100,000 person-months for breast cancer, 4.1 cases per 100,000 person-months for prostate cancer and 2.4 cases per 100,000 person-months for individuals without cancer. Two-year overall survival was 46.4 % (95 % CI 39.5, 54.5 %) for stage I–III CRC patients with concomitant endocarditis and 73.1 % (95 % CI 72.9, 73.3 %) for those without it. In this elderly population, the incidence of infective endocarditis around CRC diagnosis was substantially higher than around the diagnosis of lung, breast and prostate cancers. A concomitant diagnosis of infective endocarditis in patients with CRC diagnosis is associated with shorter survival.

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Acknowledgments

The authors acknowledge the efforts of the Applied Research Program, NCI; the Office of Research, Development and Information, CMS; Information Management Services (IMS), Inc.; and the Surveillance, Epidemiology, and End Results (SEER) Program tumor registries in the creation of the SEER-Medicare database. The interpretation and reporting of these data are the sole responsibility of the authors. The collection of the California cancer incidence data used in this study was supported by the California Department of Public Health as part of the statewide cancer reporting program mandated by California Health and Safety Code Section 103885; the National Cancer Institute’s Surveillance, Epidemiology and End Results Program under contract N01-PC-35136 awarded to the Northern California Cancer Center, contract N01-PC-35139 awarded to the University of Southern California, and contract N02-PC-15105 awarded to the Public Health Institute; and the Centers for Disease Control and Prevention’s National Program of Cancer Registries, under agreement #U55/CCR921930-02 awarded to the Public Health Institute. The ideas and opinions expressed herein are those of the author(s) and endorsement by the State of California, Department of Public Health the National Cancer Institute, and the Centers for Disease Control and Prevention or their Contractors and Subcontractors is not intended nor should be inferred. This work was partly funded by NIH Grants P01-CA134294, R01CA164023, R01HS023128. XGA is a recipient of a Grant from the Raymond P. Lavietes Foundation.

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Authors and Affiliations

  1. Department of Epidemiology, Harvard T.H. Chan School of Public Health, 677 Huntington Ave, Boston, MA, 02115, USA

    Xabier García-Albéniz, Marc Lipsitch, Roger W. Logan, Sonia Hernández-Díaz & Miguel A. Hernán

  2. Mongan Institute for Health Policy, Massachusetts General Hospital, Boston, MA, USA

    Xabier García-Albéniz & John Hsu

  3. Department of Health Care Policy, Harvard Medical School, Boston, MA, USA

    John Hsu

  4. Department of Immunology and Infectious Diseases, Harvard T.H. Chan School of Public Health, Boston, MA, USA

    Marc Lipsitch

  5. Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, MA, USA

    Miguel A. Hernán

  6. Harvard-MIT Division of Health Sciences and Technology, Boston, MA, USA

    Miguel A. Hernán

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  1. Xabier García-Albéniz
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  2. John Hsu
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  3. Marc Lipsitch
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  4. Roger W. Logan
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  5. Sonia Hernández-Díaz
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Correspondence to Xabier García-Albéniz.

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García-Albéniz, X., Hsu, J., Lipsitch, M. et al. Infective endocarditis and cancer in the elderly. Eur J Epidemiol 31, 41–49 (2016). https://doi.org/10.1007/s10654-015-0111-9

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  • DOI: https://doi.org/10.1007/s10654-015-0111-9

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