Online Program

295374
Causes of death among cancer survivors in the NIH-AARP Diet and Health Study


Sunday, November 3, 2013

Mary Jung, MPH, Department of Epidemiology and Biostatistics, University of Maryland School of Public Health, College Park, MD
Sunmin Lee, ScD, MPH, Department of Epidemiology and Biostatistics, University of Maryland School of Public Health, College Park, MD
Yikyung Park, ScD, MPH, Nutritional Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD
Background: The long-term causes of death among cancer survivors of all cancer sites have not been examined.

Objective: To evaluate the cause-specific mortality among cancer survivors in a large, prospective cohort.

Methods: In the National Institutes of Health-AARP Diet and Health Study, 73,703 cancer cases were identified through linkage to state cancer registries from 1995-2006. Cause of death was ascertained by linkage to the National Death Index (1995-2008). Cause of death among cancer survivors and non-cancer controls (n=409,228) during the first 5-years and after 5-years of follow-up were examined. Age-adjusted mortality rates were calculated.

Results: During the first 5-years of follow-up, 23,102 and 12,161 deaths were occurred among cancer survivors and non-cancer controls, respectively, whereas 4,581 and 31,028 deaths were identified among cancer survivors and non-cancer controls, respectively, after 5-years of follow-up. During the first five-years of follow-up among cancer survivors, cancer was the leading cause of death (men:81%, women:87%) followed by cardiovascular disease (men:9%, women:6%) and respiratory disease (men:2%, women:2%). After five-years of follow-up, the proportion of death from cancer decreased (men:53%, women:62%), but cardiovascular disease death (men:23%, women:16%) and respiratory disease death (men:6%, women:7%) increased among cancer survivors. After 5-years of follow-up, the cardiovascular death rate among cancer survivors (65 and 44 per 10,000 person-years in men and women, respectively) was similar to that of non-cancer controls (65 and 38 per 100,000 person-years).

Conclusion: Among cancer survivors, the probability of dying from cancer decreased with time while the probability of dying from cardiovascular disease increased.

Learning Areas:

Epidemiology

Learning Objectives:
Identify the long-term causes of death among cancer survivors. Compare causes of death among adults with and without a previous cancer diagnosis.

Keyword(s): Cancer, Mortality

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: Through my experiences as a special volunteer at the National Cancer Institute, I have become familiarized with the National Institutes of Health-AARP Diet and Health Study. I have also been a research assistant working on federally funded grants focusing on cancer prevention as well as other research projects focusing on improving cancer survivorship. Among my research interests has been providing further insight into the cancer survivorship experience.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.