Section of Biostatistics, Centre for Cancer Epidemiology, Tata Memorial Centre, Navi Mumbai, India.
Molecular Genetics Laboratory, Institute of Medical Genetics and Genomics, Sir Ganga Ram Hospital, New Delhi, India.
Cancer Rep (Hoboken). 2020 Aug;3(4):e1174. doi: 10.1002/cnr2.1174. Epub 2019 Apr 4.
Early diagnosis and improved therapeutic options have contributed to prolonged survival in male genitourinary cancer. However, these cancer survivors may die due to other causes.
This work is aimed to explore the death patterns among male genitourinary cancer patients due to other causes. The occurrence of death not related to cancer is defined as competing risk (CR).
Data extracted between 1973 and 2014 for male patients (n = 638 393) diagnosed with genitourinary cancer and registered in the Surveillance, Epidemiology, and End Results (SEER) Program were included for analysis. A CR analysis was performed to explore the death patterns due to cancer or otherwise. Our study evidenced a huge proportion of patients' death due to associated factors including but not limited to cancer. Interestingly, the computed hazard ratios obtained in cancers of male organ sites such as prepuce, glans penis, penis, and spermatic cord were 1.28 (0.98-1.67), 1.53 (1.33-1.77), 1.35 (0.19-1.53), and 1.57 (1.24-2.0), respectively. However, the hazard ratios evaluated on factors other than cancer in the same organ sites were 0.95 (0.76-1.18), 1.14 (0.99-1.3), 1.09 (0.97-1.22), and 1.12 (0.86-1.46), respectively.
This study shows that among the male genitourinary cancer patients, the significant proportion of deaths occurs due to reasons unrelated to cancer. It can be concluded that the magnitude of death due to only genitourinary cancer is minimal and is not as high as documented in the earlier literature.
早期诊断和改进的治疗选择导致男性泌尿生殖系统癌症患者的生存时间延长。然而，这些癌症幸存者可能会因其他原因死亡。
本研究旨在探讨因其他原因导致的男性泌尿生殖系统癌症患者的死亡模式。与癌症无关的死亡发生被定义为竞争风险（CR）。
我们纳入了 1973 年至 2014 年间在监测、流行病学和最终结果（SEER）计划中诊断为泌尿生殖系统癌症并登记的 638393 例男性患者的数据进行分析。采用 CR 分析来探讨因癌症或其他原因导致的死亡模式。我们的研究表明，由于包括但不限于癌症在内的各种相关因素，患者死亡的比例很大。有趣的是，在男性器官部位（如包皮、龟头、阴茎和精索）癌症中计算出的危害比分别为 1.28（0.98-1.67）、1.53（1.33-1.77）、1.35（0.19-1.53）和 1.57（1.24-2.0）。然而，在同一器官部位评估癌症以外的因素的危害比分别为 0.95（0.76-1.18）、1.14（0.99-1.3）、1.09（0.97-1.22）和 1.12（0.86-1.46）。
本研究表明，在男性泌尿生殖系统癌症患者中，相当一部分死亡是由与癌症无关的原因引起的。可以得出结论，仅由泌尿生殖系统癌症导致的死亡数量不大，并不像早期文献中记载的那么高。
