Long-Term Survival and Causes of Death After Diagnoses of Common Cancers in 3 Cohorts of U.S. Health Professionals
Menée à partir de données 1976-2013 des cohortes "the Nurses’ Health Studies" et "the Health Professionals Follow-Up Study" portant sur 28 448 femmes et 13 556 hommes atteints d'un cancer (prostate, poumon, côlon/rectum, vessie, mélanome, sein, col utérin, thyroïde), cette étude analyse la mortalité cumulée globale et spécifique 30 ans après le diagnostic chez les hommes et 35 ans après chez les femmes
Few studies investigated very long-term overall survival and causes of death among men and women diagnosed with most commonly occurring cancers.We estimated very long-term (≥30-year) overall and cause-specific cumulative mortality for men diagnosed with prostate (n = 6,873), lung and bronchus (n = 1,290), colon and rectum (n = 1,418), bladder (n = 1,321), and melanoma (n = 2,654) cancer in Health Professionals Follow-up Study between 1986-2012, and women with breast (n = 18,280), lung and bronchus (n = 3,963), colon and rectum (n = 3,461), uterine corpus (n = 1,641), and thyroid (n = 1,103) cancer in Nurses’ Health Study (NHS) between 1976-2012 and NHS II between 1989-2013.We reported overall and cause-specific cumulative mortality of 30-year among men and 35-year among women. Among male cancer survivors, the 30-year cumulative cancer-specific mortality was 15.4% (95% confidence interval [CI] = 14.4%-16.4%) for prostate, 83.5% (95% CI = 81.2%-85.5%) for lung and bronchus, 37.0% (95% CI = 34.4%-39.5%) for colon and rectum, 22.5% (95% CI = 20.0%-25.0%) for urinary bladder, and 8.0% (95% CI = 6.9%-9.1%) for melanoma. Among female cancer survivors, the 35-year cumulative cancer-specific mortality rate was 20.6% (95% CI = 19.7%-21.6%) for breast, 83.5% (95% CI = 81.6%-85.2%) for lung and bronchus, 39.6% (95% CI = 37.5%-41.6%) for colon and rectum, 16.6% (95% CI = 14.7%-18.6%) for uterine corpus, and 3.2% (95% CI = 2.1%-4.3%) for thyroid. Except for lung cancer, most common cancer patients were more likely to die from causes other than primary cancers. We observed two basic trends for cumulative cancer-specific mortality. The first one is sustained, but nevertheless excess risk: prostate or breast cancer-specific cumulative mortality continued to increase after diagnosis from 5 to ≥ 30 years. The second one is greatly diminished risk of index cancer-specific mortality following diagnosis ≥10 years: for example, colorectal-cancer-specific mortality increased by < 4 percentage points between 10 to 30- or 35-year after diagnosis, and this also applied to lung, bladder, melanoma, uterine corpus, or thyroid cancer.Except for lung cancer, patients diagnosed with common cancers were more likely to die from causes other than primary cancers. Lung, colorectal, bladder, melanoma, uterine corpus, or thyroid cancer patients surviving more than 10 years after diagnosis are unlikely to die from that disease.