Abstract LB-339: Cause of death in cancer survivors
Authors: Ning Yi , Shen Qin , Herrick Kirsten , Mikkelsen Ross , Anscher Mitchell , Houlihan Robert , Lapane Kate 
Published: August 2012

Abstract
Background: Cancer, in general, is regarded as one of the most life threatening diseases. In the past decade, with the application of advanced scientific and medical technologies for cancer early detection, prevention, and treatment, cancer survivors are now living much longer and do not died directly from cancer, but from other diseases and complications, therefore, becomes increasingly important to understand major causes of death among cancer survivors to improve the quality of life and prolong life expectancy of cancer survivors. We conducted a study to investigate the cause of death among cancer survivors using data from national surveys. Methods: The analytical population consist of 1807 cancer survivors identified from the National Health and Nutrition Examination Survey (NHANES) III 1988-1994 and NHANES 1999- 2004. We excluded participants with age less than 18 years old and those with skin cancer. Cancer survivors were identified if they self-reported having ever been told by a doctor or other health professional that he/she had cancer or a malignancy of any kind. The cause of death was ascertained through the National Death Index (NDI). All participants were followed from the date of survey to the date of the survey to December 31, 2006 by linking NDI death certificate records. Results: The Follow-up time ranged from 0 to 17.3 years. Total 776 participants died during the follow-up period. Underlying cause of death were recoded as 113 death causes in the National Death Index. We classified all death causes into 3 categories: related with cancer, indeterminate and not related with cancer. The causes of death were stratified by the duration since the diagnosis of cancer, which was calculated as follow-up time plus years between age at NHANES survey and age when being diagnosed with cancer. Commonly reported types of cancer were prostate (n=165), breast (n=141) and colorectal cancer (n=117) among 761 male and 1046 female participants. At time of the survey, there were 17.7% and 26.5% with diabetes, 63.2 and 66.9 with cardiovascular condition, and 58.7 and 62.9 had hypertension, and 61.3% and 70.5% with hypercholesterolemia in men and women, respectively. Among the deseeded cancer survivor, 41.8%, 9.3, and 48.9% were died from cancer, indeterminate, disease not related with cancer. The percentages were 43.4%, 6.2% and 50.4%, respectively in men and 40.4%, 12.1% and 47.6%, respectively in women. Noticeably, with the increase of the duration since diagnosis of cancer, higher percentage of cancer survivor died from disease not related to cancer, ranging from 23.3% within 5 years to 72.1% in more than 30 years (p value for trend &lt;0.001). Conclusion: Although cancer is the major cause of death among cancer survivors, approximately half of participants died from other diseases and complications, such as cardiovascular and respiratory diseases. Clinicians and cancer survivors should pay attention to the prevention and treatment of other diseases and complications.
Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 103rd Annual Meeting of the American Association for Cancer Research; 2012 Mar 31-Apr 4; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2012;72(8 Suppl):Abstract nr LB-339. doi:1538-7445.AM2012-LB-339