Temporal trends in the leading causes of death among a large national cohort of patients with colorectal cancer from 1975 to 2009 in the United States
A partir des données de 9 registres américains des cancers portant sur 375 462 patients atteints de cancer colorectal, cette étude de cohorte analyse l'évolution de la proportion de décès liés à une autre cause que le cancer et évalue l'évolution de la mortalité spécifique, sur la période 1975-2009
Purpose : To assess the distribution of proportion of deaths from causes other than colorectal cancer (CRC) over time and temporal trends of cause-specific cumulative incidence of death due to six leading causes in patients with CRC. Methods : 375,462 patients with CRC in 9 SEER (Surveillance, Epidemiology, and End Results) registries from 1975-2009 were included. Competing risks proportional hazards regression was used to examine the effect of diagnostic time periods on the risk of cause-specific death. Results : From 1975-2009 by 5-year interval, the proportion of deaths from causes other than CRC increased significantly with diagnostic time periods according to the lengths of follow-up (p<0.0001). The 5-year risk of death significantly decreased with diagnostic time periods for all-cause, CRC and circulation diseases among all age groups (<65, 65-74, ≥75), but increased for chronic obstructive pulmonary disease (COPD), diabetes, and Alzheimer’s disease among patients aged ≥65. Conclusion : Deaths due to causes other than CRC increased significantly over time regardless of tumor stage and site but more sharply in those with early-stage and distal colon cancer. The increasing leading causes of death are COPD, diabetes, and Alzheimer’s disease, which may be prevented or delayed substantially by modification or intervention in lifestyle or other factors.