Cancer Patients Mortality From Other Causes: A European Population‐Based Study
ABSTRACT Introduction Cancer patients may face elevated mortality not only from their malignancy but also from other factors including multi‐morbidity and the impact of treatment‐related complications. This study analyses mortality from all causes other than the index cancer among cancer patients compared to the general population. Methods We analysed EUROCARE‐6 data on 1,894,057 cancers diagnosed in 13 European countries and collected by 17 cancer registries with complete official cause‐of‐death information. Included were first‐primary head and neck (H&N), stomach, colorectal, lung, breast, cervical, endometrial, ovarian, prostatic, kidney, and bladder cancers diagnosed between 1998 and 2013 in patients aged 15–79, with follow‐up until 31st December 2014. We estimated the relative risk (RR) of death from all other causes for patients relative to population mortality rates. Cause‐specific survival (CSS) was compared to relative survival (RS) at 5 and 10 years. Results RR were > 2 for H&N and female lung cancers, between 1 and 2 for stomach, male lung, cervix, endometrial, ovary, kidney and bladder, and < 1 for prostate and female breast cancers. Relative risk declined with increasing age for almost all cancer types. Ten‐year CSS exceeded RS by 7%–11% points (pp) in H&N cancers, with smaller differences in bladder (2–6 pp), stomach, lung, cervix, ovary and kidney (2–3 pp). CSS was lower than RS in breast and prostate cancers. Conclusion Differentiation between deaths due to the index cancer and to all other causes is crucial for patient follow‐up and to improve quality of life. Cause‐of‐death data should be a core component of population‐based cancer registries to inform interpretation of survivorship data.