Causes of death in endometrial cancer survivors: A Surveillance, Epidemiology, and End Result–based analysis

Abstract

Background Increasing attention has been paid to the survival of endometrial cancer (EC) patients, but the non‐cancer causes of death from EC are rarely reported. This study primarily aimed to investigate the non‐cancer causes of death in patients with EC. Methods The study collected relevant data, including age, tumour stage and treatment mode, on patients diagnosed with endometrial malignancies from 2000 to 2015 in the Surveillance, Epidemiology, and End Results (SEER) Programme. We analysed the standardised mortality ratio (SMR) to determine the cause of death. Results The study included 135,831 patients with EC. During the follow‐up, 46,604 (34.3%) patients died, of whom 42.9%, 15.6% and 41.5% died of EC, other cancers and non‐cancer causes, respectively. As the diagnosis time increased, the number of EC‐associated mortalities gradually decreased. The most common non‐cancer causes of death were heart disease, cerebrovascular disease and diabetes. Regarding the general population of the United States, patients with EC died of heart disease (SMR: 1.06; 95% confidence interval [CI]: 1.03–1.09), diabetes (SMR: 1.56; 95% CI: 1.47–1.65) and septicaemia (SMR: 1.40; 95% CI: 1.28–1.52), which were statistically significant. Conclusions For patients with EC, the number of deaths from non‐cancer causes (mainly heart disease, cerebrovascular disease and diabetes mellitus) is equivalent to that of EC. In addition, compared with the general population, EC survivors have a higher risk of death from sepsis and diabetes. These discoveries support how survivors can avoid future‐related health risks. By doing this, clinicians can improve the quality of life and chances of the survival of patients with EC.

Cause of death among gastric cancer survivors in the United States from 2000 to 2020

“…on other cancers. [12][13][14][15][16][17] Most causes of death had a significantly higher risk of death compared to cancer-free populations in the United States. The risks of death from the majority of COD demonstrated a downward trend over time.…”

“…[11] The most common noncancerous causes of death were diseases of heart and cerebrovascular diseases, which were consistent with findings from several previous studies on various cancers. [11][12][13][14][15][16][17][18] This association may be related to GC treatment. For example, immunotherapy is probably associated with cardiac toxic effects, and HER-2 targeted Trastuzumab may lead to a decrease in left ventricular ejection fraction.…”

“…The main noncancerous causes of death were diseases of heart, cerebrovascular disease and COPD, which paralleled previous studies on other cancers. [12–17] Most causes of death had a significantly higher risk of death compared to cancer-free populations in the United States. The risks of death from the majority of COD demonstrated a downward trend over time.…”

Quality of life in endometrial cancer survivors by grade of disease

“…Similarly, there was no association between higher levels of physical activity and increased QOL, in contrast to findings in EC survivors by Courneya et al, who reported EC survivors who met public health guidelines for exercise had a higher QOL score compared to those who did not meet the recommended guidelines 29 . While the findings are still mixed with respect to physical activity and obesity, a recent population‐based study noted that nearly as many EC survivors died of other causes such as cardiovascular and cerebrovascular diseases at similar rates of succumbing to EC, suggesting that recommendations for physical activity and body size are important in this population for overall survival 30 …”

Metabolic Syndrome and Survival Outcomes in Endometrial Cancer

“…Heart disease constituted the leading non-cancer cause of death (12.8%), followed by cerebrovascular disease (3.3%), diabetes mellitus (2.3%), and Alzheimer's disease (2.2%). Interestingly, EC survivors displayed a consistently elevated risk of death from diabetes compared to the general population [54].…”