Introduction

Non-cancer events are important causes of competing mortality among cancer patients. However, the risk of non-cancer death and risk classification in middle-aged cancer patients is not clear. To comprehensively analyze the risk of non-cancer deaths in 24 different cancers among middle-aged patients.

Methods

Standardized mortality rate (SMR), absolute excess risk (AER), proportion of deaths, age-adjusted mortality rate (AAMR), and the competing model were used to assess the risk of non-cancer death in middle-aged cancer patients. A non-cancer death risk classification was developed for the 24 cancer types based on the competing risk of non-cancer death and the risk of non-cancer death (hazard ratio).

Results

A total of 1,082,030 middle-aged cancer patients of 24 cancer types was identified. The risk of non-cancer death was elevated in middle-aged cancer patients compared to the general middle-aged population (SMR = 3.37, 95 % CI 3.35–3.39, AER = 99.18). The cumulative mortality was higher for non-cancer causes compared to primary cancer in 15 cancer types. The AAMR for non-cancer causes declined from 2.3 % in 1975 to 1.4 % in 2017. A risk classification was developed to classify different cancers into 6 risk categories.

Conclusion

The risk of non-cancer death was elevated in middle-aged cancer patients and varied for different cancer types. A new risk classification system was developed to estimate the risk of non-cancer deaths in different cancers, and the 24 cancer types were classified into 6 distinct categories. These results highlight the necessity for risk stratification management for non-cancer death in middle-aged cancer patients.

中文翻译：

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中年癌症患者非癌性死亡风险分级

 介绍

非癌症事件是癌症患者竞争性死亡率的重要原因。然而，中年癌症患者非癌症死亡的风险和风险分类尚不清楚。全面分析中年患者 24 种不同癌症的非癌症死亡风险。

 方法

采用标化死亡率 （SMR） 、绝对超额风险 （AER） 、死亡比例、年龄调整死亡率 （AAMR） 和竞争模型评估中年癌症患者非癌死亡风险。根据非癌症死亡的竞争风险和非癌症死亡的风险（风险比），为 24 种癌症类型开发了非癌症死亡风险分类。

 结果

共确定了 24 种癌症类型的 1,082,030 名中年癌症患者。与一般中年人群相比，中年癌症患者的非癌症死亡风险升高 （SMR = 3.37,95% CI 3.35-3.39，AER = 99.18）。在 15 种癌症类型中，与原发性癌症相比，非癌症原因的累积死亡率更高。非癌症原因的 AAMR 从 2.3 年的 1975% 下降到 1.4 年的 2017%。开发了风险分类，将不同的癌症分为 6 个风险类别。

 结论

中年癌症患者的非癌症死亡风险升高，并且因癌症类型而异。开发了一种新的风险分类系统来估计不同癌症中非癌症死亡的风险，并将 24 种癌症类型分为 6 个不同的类别。这些结果强调了中年癌症患者非癌症死亡风险分层管理的必要性。