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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Article info
Publication history
Published online: October 20, 2022
Accepted:
October 17,
2022
Received:
December 13,
2021
Identification
Copyright
© 2022 Southern Society for Clinical Investigation. Published by Elsevier Inc. All rights reserved.
