Feng Yuqian, Jin Huimin, Guo Kaibo, Wasan Harpreet S, Ruan Shanming, Chen Cihui
The First Clinical College of Zhejiang Chinese Medical University, Hangzhou, China.
Department of Cancer Medicine, Hammersmith Hospital, Imperial College Healthcare National Health Service Trust, London, United Kingdom.
Front Oncol. 2021 Mar 30;11:647179. doi: 10.3389/fonc.2021.647179. eCollection 2021.
Non-cancer causes of death in patients with colorectal cancer (CRC) have not received much attention until now. The purpose of the current study is to investigate the non-cancer causes of death in patients with CRC at different periods of latency. Eligible patients with CRC were included from the Surveillance, Epidemiology, and End Results (SEER) database, and standardized mortality ratios (SMRs) were calculated using the SEER*Stat software 8.3.8. A total of 475,771 patients with CRC were included, of whom 230,841 patients died during the follow-up period. Within 5 years, CRC was the leading cause of death. Over time, non-cancer causes of death account for an increasing proportion. When followed up for more than 10 years, non-cancer deaths accounted for 71.9% of all deaths worldwide. Cardiovascular diseases were the most common causes of non-cancer deaths, accounting for 15.4% of the total mortality. Patients had a significantly higher risk of death from septicemia within the first year after diagnosis compared with the general population (SMR, 3.39; 95% CI, 3.11-3.69). Within 5-10 years after CRC diagnosis, patients had a significantly higher risk of death from diabetes mellitus (SMR, 1.27; 95% CI, 1.19-1.36). During the course of more than 10 years, patients with CRC had a significantly higher risk of death from atherosclerosis (SMR 1.47; 95% CI, 1.11-1.9). Although CRC has always been the leading cause of death in patients with CRC, non-cancer causes of death should not be ignored. For patients with cancer, we should not only focus on anti-tumor therapies but also pay attention to the occurrence of other risks to prevent and manage them in advance.
直到现在，结直肠癌（CRC）患者的非癌症死亡原因仍未受到太多关注。本研究的目的是调查CRC患者在不同潜伏期的非癌症死亡原因。从监测、流行病学和最终结果（SEER）数据库中纳入符合条件的CRC患者，并使用SEER*Stat软件8.3.8计算标准化死亡率（SMR）。共纳入475,771例CRC患者，其中230,841例患者在随访期间死亡。5年内，CRC是主要死亡原因。随着时间推移，非癌症死亡原因所占比例不断增加。随访超过10年时，非癌症死亡占全球所有死亡的71.9%。心血管疾病是最常见的非癌症死亡原因，占总死亡率的15.4%。与普通人群相比，患者在诊断后第一年内因败血症死亡的风险显著更高（SMR，3.39；95%CI，3.11 - 3.69）。在CRC诊断后的5至10年内，患者因糖尿病死亡的风险显著更高（SMR，1.27；95%CI，1.19 - 1.36）。在超过10年的病程中，CRC患者因动脉粥样硬化死亡的风险显著更高（SMR 1.47；95%CI，1.11 - 1.9）。尽管CRC一直是CRC患者的主要死亡原因，但非癌症死亡原因不应被忽视。对于癌症患者，我们不仅应关注抗肿瘤治疗，还应注意其他风险的发生，提前预防和管理这些风险。
