Incidence of Death From Unintentional Injury Among Patients With Cancer in the United States

Abstract

IMPORTANCE Previous studies have suggested that patients with cancer may be at an increased risk of death from unintentional injury, but to our knowledge, no large studies have examined the rates of death from unintentional injury among patients with cancer. OBJECTIVE To characterize the incidence of death from unintentional injury among patients with cancer in the United States. DESIGN, SETTING, AND PARTICIPANTS This retrospective cohort study included patients diagnosed with a first primary cancer between January 1, 1973, and December 31, 2015, identified from the Surveillance, Epidemiology, and End Results (SEER) program data. Comparisons with the general US population were based on mortality data collected by the National Center for Health Statistics. Analyses were performed from February 1, 2019, to August 15, 2019. MAIN OUTCOMES AND MEASURES Rates and standardized mortality ratios (SMRs) of death from unintentional injury among patients with cancer. RESULTS A total of 8 271 020 patients with cancer were included in this study (50.2% female; mean [SD] age, 63.0 [15.7] years). Among them, 40 599 deaths from unintentional injury were identified. The rates of death from unintentional injury were 81.90 per 100 000 person-years among patients with cancer and 51.21 per 100 000 person-years in the corresponding US general population. The

Fatal Infections Among Cancer Patients: A Population-Based Study in the United States

“…The mortality rates of fatal infections were calculated as the number of deaths from infections divided by person-years of follow-up, whereas the SMRs and corresponding 95% confidence intervals (CIs) of non-cancer deaths were calculated based on previously published protocols [16][17][18][19]. The SMRs were estimated as the ratios of observed to expected number of deaths.…”

“…1 show the SMRs of infectious mortality by time since cancer diagnosis. With all cancer types combined, the SMR of deaths from infectious diseases was high within 1 year after cancer diagnosis (SMR, 5.09; 95% CI 5.04-5.14), decreased in the first 5 years after diagnosis, rose gradually since 5 years after diagnosis, and reached a peak after [ 19). In various types of cancer, three patterns were observed in the risk of dying from infectious diseases with follow-up time.…”

Cause of death among patients with colorectal cancer: a population-based study in the United States

“…First, there is a risk of reporting bias in death certificates which could lead to misclassification of causes of death [ 53 , 54 ]. However, the SEER mortality data were provided by the NCHS (National Center for Health Statistics) and NVSS (National Vital Statistics System) and systematic and standardized data collection procedures are used to ensure that the causes of death recorded in SEER are accurate [ 55 ]. Further, previous studies have also examined the validity and reliability of the use of death certificates recorded in the SEER and the results suggested that they were acceptable [ 56 , 57 ].…”

“…Thus, we were not able to analyze the cause and effect relationship between different risk factors and distinct causes of death. Nevertheless, analyzing the extensive amount of data available from the SEER database remains a powerful, useful, and integral tool in medical research for the purpose of exploratory analyses [ 55 ]. Third, we were unable to obtain data on genetic information (such as MMR (defective mismatch repair) genes or mutations status of KRAS and BRAF) and dietary habits, which prohibited us from taking these features into account.…”

“…Mortality rates were calculated as the number of deaths divided by the total person-years of follow-up. For non-cancer causes, the SMRs and 95% CIs of non-cancer deaths were calculated to perform a comparison with the general population [ 55 , 61 – 63 ]. The SMR is based on the assumptions that the general population is cancer-free, and thus it can be used to compare the mortality rates from non-cancer diseases (e.g.…”