Cause specific mortality within the first years of follow-up after diagnosis of cancer

Abstract

Background: Cancer accounts for 24% of all deaths in Germany. With improving survival rates, it is to be expected that other competing causes of death among cancer patients will become more relevant. Objectives: The aim of the present study was to characterize the causes of death of cancer patients in Baden–Württemberg, Germany, and compare the risk of death from noncancer causes with the expected risk in the general population. Materials and methods: The mortality pattern of cancer patients between 2013 and 2020 was examined using data from the Cancer Registry of Baden–Württemberg. Standardized mortality ratios (SMRs) including 95% confidence intervals (CI) were calculated to assess cause-specific mortality in cancer patients in comparison to the general population. Results: Out of 144,949 deaths, 16.2% were due to noncancer causes, with cardiovascular diseases being the most common. Compared with the general population, cancer patients showed increased mortality rates from infections (SMR: 1.56 [CI: 1.46–1.65]), liver diseases (2.02 [CI: 1.90–2.14]), and suicide (1.94 [CI: 1.76–2.11]). Overall, the highest SMRs were found in patients after a lung cancer diagnosis, young patients, and during the first year after diagnosis. Conclusion: Although cancer remains the most frequent cause of death in oncological patients within the first years after diagnosis, cancer patients are at increased risk regarding other competing causes of death such as infections, cardiovascular diseases, liver diseases, and suicide. These patterns might reflect potential therapy-related late effects but also shared risk factors for cancer and other diseases.