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Prior cancer diagnosis and mortality profile in US adults

  • Yutang Wang
    Correspondence
    Corresponding author: Yutang Wang, Discipline of Life Science, School of Science, Psychology and Sport, Federation University Australia, Ballarat, VIC, 3350, Australia. Tel: 61-3-53279394
    Affiliations
    Discipline of Life Science, School of Science, Psychology and Sport, Federation University Australia, Ballarat, VIC, Australia
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  • Yan Fang
    Affiliations
    Discipline of Life Science, School of Science, Psychology and Sport, Federation University Australia, Ballarat, VIC, Australia
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  • Christopher G. Sobey
    Affiliations
    Centre for Cardiovascular Biology and Disease Research and Department of Microbiology, Anatomy, Physiology & Pharmacology, School of Agriculture, Biomedicine & Environment, La Trobe University, Melbourne, VIC, Australia
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  • Grant R. Drummond
    Affiliations
    Centre for Cardiovascular Biology and Disease Research and Department of Microbiology, Anatomy, Physiology & Pharmacology, School of Agriculture, Biomedicine & Environment, La Trobe University, Melbourne, VIC, Australia
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Published:October 20, 2022DOI:https://doi.org/10.1016/j.amjms.2022.10.008

      ABSTRACT

      BACKGROUND

      Mortality profiles with multivariate adjustment in patients with a prior cancer diagnosis are scarce. This study aimed to investigate multivariate-adjusted mortality profile in US adults with a prior cancer diagnosis.

      METHODS

      This cohort study included 58,109 US adults (5,016 with a prior cancer diagnosis) who attended the National Health and Nutrition Examination Survey. Mortality outcomes were ascertained by linkage to the National Death Index records. Cox proportional hazards models were used to estimate hazard ratios (HRs) and confidence intervals (CIs) of prior cancer diagnosis for mortality.

      RESULTS

      This cohort was followed up for 646,033 person-years with a mean follow-up of 11.1 years. Compared with those without cancer, participants with a prior cancer diagnosis had increased crude cumulative mortality rates in each leading cause. Prior cancer diagnosis was associated with a higher multivariate-adjusted risk of mortality from all causes (HR, 1.29; 95% CI, 1.22-1.35), cancer (HR, 2.32; 95% CI, 2.10-2.56), and accidents (HR, 1.90; 95% CI, 1.34-2.68). Prior cancer diagnosis-associated increase in accident mortality appeared only in males and was significant only in non-Hispanic black participants. Prior cancer diagnosis-associated increase in cancer mortality appeared high in non-Hispanic black participants.

      CONCLUSIONS

      This study found that patients with a prior cancer diagnosis had higher multivariate-adjusted accident mortality risks, suggesting that oncologists may need to evaluate accident risks in cancer patients and provide preventive interventions in particular for male and non-Hispanic black patients. Increased cancer mortality risk associated with prior cancer diagnosis in non-Hispanic black participants may also need clinical attention.

      Keywords

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