Data Modeling Branch, Surveillance Research Program, Division of Cancer Control and Population Sciences, National Cancer Institute, 9609 Medical Center Drive, Room 4E568, Bethesda, MD 20892, USA.
Am J Epidemiol. 2013 Aug 1;178(3):339-49. doi: 10.1093/aje/kws580. Epub 2013 Jul 3.
With advances in prevention, screening, and treatment, cancer patients are living longer; hence, non-cancer-related health status will likely play a larger role in determining their life expectancy. In this study, we present a novel method for characterizing non-cancer--related health status of cancer patients using population-based cancer registry data. We assessed non-cancer-related health status in the context of survival from other causes of death and prevalence of comorbidities. Data from the Surveillance, Epidemiology, and End Results program (2000-2006) were used to analyze cancer patients' survival probabilities by cause of death. Other-cause survival was estimated using a left-truncated survival method with the hazard of death due to other causes characterized as a function of age. Surveillance, Epidemiology, and End Results data linked to Medicare claims (1992-2005) were used to quantify comorbidity prevalence. Relative to the US population, survival from a non-cancer-related death was higher for patients diagnosed with early stage breast and prostate cancer but lower for lung cancer patients at all stages. Lung cancer patients had worse comorbidity status than did other cancer patients. The present study represents the first attempt to evaluate the non-cancer-related health status of US cancer patients by cancer site (breast, prostate, colorectal, and lung) and stage. The findings provide insight into non-cancer-related health issues among cancer patients and their risk of dying from other causes.
随着预防、筛查和治疗的进步,癌症患者的寿命越来越长;因此,与癌症无关的健康状况可能在更大程度上决定他们的预期寿命。在这项研究中,我们提出了一种使用基于人群的癌症登记数据来描述癌症患者与癌症无关的健康状况的新方法。我们评估了在其他原因导致的死亡和合并症的患病率的背景下,与癌症无关的健康状况。利用监测、流行病学和最终结果计划(2000-2006 年)的数据,分析了癌症患者因不同原因导致的生存概率。采用左截断生存方法估计其他原因的生存概率,将其他原因导致的死亡风险特征化为年龄的函数。利用监测、流行病学和最终结果数据与医疗保险索赔(1992-2005 年)进行关联,量化了合并症的患病率。与美国人口相比,早期诊断的乳腺癌和前列腺癌患者因与癌症无关的原因而死亡的生存概率较高,而所有阶段的肺癌患者的生存概率较低。肺癌患者的合并症状况比其他癌症患者更差。本研究首次尝试按癌症部位(乳腺、前列腺、结直肠和肺)和阶段评估美国癌症患者的与癌症无关的健康状况。这些发现为癌症患者的与癌症无关的健康问题及其因其他原因死亡的风险提供了一些见解。