Saad Muhammad, Batool Ruqiat Masooma, Waqas Saad Ahmed, Sohail Muhammad Umer, Mohan Anmol, Kumar Vikash, Hameed Ishaque, Ahmed Raheel, Alraies M Chadi
Department of Medicine, Dow University of Health Sciences, Karachi, Pakistan.
Department of Medicine, Mayo Clinic, Rochester, USA.
Thromb Res. 2025 Mar;247:109259. doi: 10.1016/j.thromres.2025.109259. Epub 2025 Jan 23.
While cancer mortality rates in the United States (U.S.) have decreased due to advances in chemotherapy, older adults with cancer face an elevated risk of venous thromboembolism (VTE). This study analyzes trends in cancer-associated VTE mortality among older adults in the U.S.
Using the CDC WONDER multiple cause of death (MCD) database, we reviewed death certificates from 1999 to 2020 to assess cancer-associated VTE mortalities among older adults (≥65 years old). We report age-adjusted mortality rates (AAMRs) per 100,000 persons, along with the average annual percent change (AAPC) using Joinpoint regression.
Over the study period, 175,811 cancer-associated VTE deaths were recorded. The AAMR rose from 16.8 in 1999 to 22.8 in 2020, with an AAPC of +1.4 % (95 % CI: 1.2-1.6; p < 0.001). Males had a higher AAMR (22.2) than females (17.0). Non-Hispanic (NH) Black individuals had the highest AAMR (28.3), followed by NH Whites (19.3), Hispanics (12.0), and NH Asians (7.9). AAMRs were higher in nonmetropolitan areas (19.4) than urban counterparts (19.1). Regionally, the Midwest recorded the highest AAMR at 20.9. States in the top 90th percentile reported double the AAMRs compared to those in the bottom 10th percentile.
Cancer-associated VTE mortality rates are rising among older adults in the U.S., highlighting the need for enhanced screening, aggressive management, and consistent surveillance for VTE in cancer patients at risk.
尽管由于化疗进展，美国癌症死亡率有所下降，但老年癌症患者面临静脉血栓栓塞（VTE）风险升高。本研究分析了美国老年人群中癌症相关VTE死亡率的趋势。
利用美国疾病控制与预防中心（CDC）的多死因（MCD）数据库，我们回顾了1999年至2020年的死亡证明，以评估老年人群（≥65岁）中与癌症相关的VTE死亡率。我们报告每10万人的年龄调整死亡率（AAMR），以及使用Joinpoint回归分析的年均变化百分比（AAPC）。
在研究期间，共记录了175,811例与癌症相关的VTE死亡病例。AAMR从1999年的16.8上升至2020年的22.8，AAPC为+1.4%（95%CI：1.2-1.6；p<0.001）。男性的AAMR（22.2）高于女性（17.0）。非西班牙裔（NH）黑人的AAMR最高（28.3），其次是NH白人（19.3）、西班牙裔（12.0）和NH亚裔（7.9）。非都市地区的AAMR（19.4）高于城市地区（19.1）。在区域方面，中西部地区的AAMR最高，为20.9。处于第90百分位数以上的州报告的AAMR是处于第10百分位数以下州的两倍。
美国老年人群中与癌症相关的VTE死亡率正在上升，这凸显了对有风险的癌症患者加强VTE筛查、积极管理和持续监测的必要性。
