• Cancer medicine · Mar 2020

    Causes of death among cancer patients in the era of cancer survivorship in Korea: Attention to the suicide and cardiovascular mortality.

    • Chang-Mo Oh, Dahhay Lee, Hyun-Joo Kong, Seokmin Lee, Young-Joo Won, Kyu-Won Jung, and Hyunsoon Cho.
    • Department of Preventive Medicine, School of Medicine, Kyung Hee University, Seoul, Republic of Korea.
    • Cancer Med. 2020 Mar 1; 9 (5): 1741-1752.

    BackgroundImproved cancer survival is expected to increase noncancer deaths; however, detailed causes of death have rarely been discussed. Changing landscapes in mortality patterns and noncancer mortality risks in patients with cancer require evaluation.MethodsWe identified cancer and noncancer-related causes of death using data from the 2000-2016 national cancer registry in Korea (n = 2 707 520), and we characterized the leading causes of death and proportionate mortalities over time. Risks of noncancer deaths relative to the general population were estimated using standardized mortality ratios (SMRs).ResultsOf 1 105 607 identified deaths, 87% were due to the primary cancer. Proportionate mortalities of primary cancer among overall deaths remained high in patients with liver (86%) and lung (70%) cancers and in female patients with breast cancer (77%), even 5 to 10 years following diagnosis, whereas proportionate mortalities reduced to ≤50% in patients with stomach (men, 39%; women, 48%), prostate (47%), and female thyroid (27%) cancers. Despite the predominance of index cancer deaths, the proportion of noncancer deaths among all deaths increased over time. There was a 20-fold increase in cardiovascular disease deaths among patients with cancer from 2000 to 2016, and the risk of suicide among patients with cancer was higher than that among the general population (SMR: 1.68 [95% confidence interval (CI): 1.63-1.74] in men, SMR: 1.42 [95% CI: 1.33-1.55] in women).ConclusionsDeaths from primary cancer remain a major concern; however, follow-up is required for both cancer and noncancer-related health issues in cancer survivors, especially concerning suicide and cardiovascular deaths.© 2020 The Authors. Cancer Medicine published by John Wiley & Sons Ltd.

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