Abstract
BackgroundPopulation-based analysis for the short-term non-bladder cancer related mortality among patients with non-metastatic bladder cancer is currently lacking. The objective of the current study was to assess and quantify cause of death after bladder cancer diagnosis.MethodsThe custom Surveillance, Epidemiology, and End Results (SEER) dataset for standardized mortality ratios (SMRs) was utilized to identify 24,074 patients who were diagnosed with nonmetastatic (M0) bladder cancer from 2014 to 2015. SMRs for causes of death were calculated. Risk factors for bladder cancer-specific mortality, competing mortality, second-cancer mortality, and noncancer mortality were determined using either multivariable Cox or competing risk regression models.ResultsAmong all the 4179 (17.4%) deaths occurred during the follow-up period, almost half of them (44.2%) were attributed to non-bladder cancer cause, including second non-bladder cancer (10%) and other non-cancer causes (34.2%). The most common noncancer causes of death were heart diseases followed by chronic obstructive pulmonary disease. Patients had a higher risk of death from second malignancies (SMR, 1.59; 95% CI, 1.47–1.74) compared with death from first malignancies in the US general population, and also had higher risks of death from heart diseases (SMR, 1.29; 95% CI, 1.18–1.40) and chronic obstructive pulmonary disease (SMR, 1.52; 95% CI, 1.29–1.79) compared with the US general population. Additionally, some risk factors for competing second malignancies or noncancer mortality were determined, such as age, gender, marital status and treatment modalities.ConclusionsDeath from non-bladder cancer cause contributed to almost half of all deaths in bladder cancer survivors during the short-term follow-up period. These findings can inform medical management and assist clinicians in counseling those survivors regarding their short-term health risks.
Highlights
Population-based analysis for the short-term non-bladder cancer related mortality among patients with non-metastatic bladder cancer is currently lacking
Zhai et al BMC Cancer (2020) 20:1148 bladder cancer (NMIBC) at diagnosis, whereas the remaining ~ 30% are classified as muscle-invasive bladder cancer (MIBC) [6]
The results identify patients who are at higher risk to die from second non-bladder cancers, as well as who are at higher risk of non-cancer death
Summary
Population-based analysis for the short-term non-bladder cancer related mortality among patients with non-metastatic bladder cancer is currently lacking. Approximately 70% of bladder cancers are classified as localized disease or non-muscle-invasive. Zhai et al BMC Cancer (2020) 20:1148 bladder cancer (NMIBC) at diagnosis, whereas the remaining ~ 30% are classified as muscle-invasive bladder cancer (MIBC) [6]. A previously published large population-based analysis reported that the 5-year cancer-specific survival rates was 92 and 50% for localized and regional disease, respectively [7]. Considering the elder age and improved lifetime expectance of bladder cancer survivor, more attention should be paid to identify the cancer patients at high risk of dying from non-bladder cancer cause, as well as their risk of a particular cause of death
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