Abstract A002: Cardiovascular diseases predominate inflammaging causes of death among patients with prostate cancer: A population-based analysis using the SEER database
Authors: Ebied Amr , Ali Abdelrahman , Bakour Chighaf 
Published: February 2024

Inflammaging, characterized by chronic low-grade systemic inflammation, is a hallmark of physiological aging. It has been postulated as a unifying risk factor for various age-related conditions encompassing cardiovascular, pulmonary, hepatic, renal, articular, and neurological diseases, giving rise to the concept of 'age-related diseases of inflammation.' Recent research has unveiled a significantly increased prevalence of antecedent age-related diseases of inflammation in patients with hematologic malignancies. Consequently, we posit that the risk of mortality due to cardiovascular diseases in patients with solid cancers such as prostate cancer surpasses that attributed to other causes. We conducted a population-based analysis utilizing the Surveillance, Epidemiology, and End Results (SEER 17) data spanning from 2000 to 2019. A total of 70,715 prostate cancer patients meeting our selection criteria were included in the analysis. We calculated standardized mortality ratios (SMRs) and utilized competing risk analysis. Within this cohort, 3,217 (4.5%) died of cardiovascular causes as compared to 67,498 (95.5%) due to non-cardiovascular causes. Among patients over 50 years of age, the proportion of deaths due to cardiovascular diseases (CVD) was significantly larger than that of other causes (99.41% versus 97.58%, p &lt;0.0001). Most of the prostate cancer patients who died due to CVD were above 50 years of age (99.41%), white (76.75%), diagnosed with adenocarcinoma (99.96%), of intermediate (44.26%) and high-grade disease (30.56%), diagnosed with localized disease (91.97%), had radiotherapy (98.57%), no surgery (93.94%), no chemotherapy (98.38%), and no metastasis at diagnosis (96.05%). Prostate cancer cases above 50 years of age were 33% less likely to die from CVD after a diagnosis of prostate cancer in comparison to a reference US population of the same age and racial distribution (SMR= 0.67, 95% CI= 0.65-0.69, absolute excess ratio (AER)= -35.96 per 10,000 PYR), most probably reflecting a decline in the incidence of CVD-related deaths with time. However, the cumulative incidence of CVD deaths was higher in cases above 50 years of age as compared to cases at or below 50. Finally, taking prostate cancer-specific deaths, other cause deaths, and other cancer-specific deaths as competing risk factors to CVD deaths, and after adjustment for potential confounders, we found that cases of prostate cancer above 50 years of age were nearly 3.5 times more likely to die from CVD as compared to cases at or below the age of 50 (Subdistribution hazard ratio (SDHR)= 3.65, 95%CI= 2.32-5.73). In conclusion, despite a declining trend, CVDs are predominant contributors to mortality in prostate cancer patients. Consequently, there is a compelling need to investigate similar mortality patterns across other cancer types and to explore potential associations with genetic and treatment-related factors.

Citation Format: Amr Ebied, Abdelrahman Ali, Chighaf Bakour. Cardiovascular diseases predominate inflammaging causes of death among patients with prostate cancer: A population-based analysis using the SEER database [abstract]. In: Proceedings of the AACR Special Conference in Cancer Research: Translating Cancer Evolution and Data Science: The Next Frontier; 2023 Dec 3-6; Boston, Massachusetts. Philadelphia (PA): AACR; Cancer Res 2024;84(3 Suppl_2):Abstract nr A002.