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Abstract
Introduction. Recent decades have witnessed a decline in mortality rates from malignant neoplasms (MN). However, cancer patients face a substantially elevated risk of death from non-cancer causes compared to the general population.
Aim. To evaluate non-cancer mortality patterns among patients with the 12 most prevalent MNs using data from the population-based cancer registry of the Arkhangelsk Region and Nenets Autonomous Okrug (PBR AO and NAO), and to quantify the relative risk of non-cancer mortality in cancer patients versus the general population.
Materials and Methods. We analyzed data on patients with 12 invasive MNs diagnosed between 2008–2023 from the PBR AO and NAO database. Mortality patterns were assessed for: index malignant neoplasms (iMNs), non-index MNs, and non-oncologic causes. Age-standardized mortality ratios (SMRs) were calculated for cardiovascular (CVD) and respiratory diseases (RD) in cancer patients relative to population controls.
Results. A total of 51,076 cancer cases were analyzed. The proportion of non-cancer deaths increased significantly from 8.9–33.2% (2008–2009) to 4.5–47.2% (2022–2023). During the COVID-19 pandemic, non-cancer mortality rose substantially across cancer types (lung cancer: 16.6%; prostate cancer: 58.0%), with RD deaths peaking at 26.7%. SMR analyses revealed markedly elevated risks: CVD mortality increased across all MNs, most notably for oral cavity (SMR 10.0, 95% CI 6.2–15.3) and cervical cancers (SMR 12.8, 95% CI 8.5–18.3) in 2022–2023. RD mortality risk exceeded population levels by 45-105 times during the pandemic.
Conclusion. Non-cancer causes constitute an increasingly significant component of overall mortality in cancer patients. The relative risk of CVD- and RD-associated mortality in this population substantially exceeds that of the general population.
References
Под ред. А.Д. Каприна, В.В. Старинского, А.О. Шахзадовой Злокачественные новообразования в России в 2023 году (заболеваемость и смертность). М.: МНИОИ им. П.А. Герцена — филиал ФГБУ «НМИЦ радиологии» Минздрава России. 2024; 276(Ил.).-ISBN 978-5-85502-298-8. [Ed. by A.D. Kaprin, V.V. Starinskiy, A.O. Shahzadova. Malignant neoplasms in Russia in 2023 (morbidity and mortality). Moscow: P.A. Herzen Moscow State Medical Research Institute - branch of the Federal State Budgetary Institution ‘NMRC of Radiology’ of the Ministry of Health of Russia., 2024. 2024; 276(ill).-ISBN 978-5-85502-298-8 (In Rus)].
International Agency for Research on Cancer. Global Cancer Observatory: Cancer Today [Internet]. Lyon: IARC; 2024 [cited 2025 Feb 14].-URL: https://gco.iarc.fr/en
Kc M., Fan J., Hyslop T., et al. Relative burden of cancer and noncancer mortality among long-term survivors of breast, prostate, and colorectal cancer in the US. JAMA Netw Open. 2023; 6(7): e2323115.-DOI: 10.1001/jamanetworkopen.2023.23115.
Валькова Л.Е., Левит М.Л., Мерабишвили В.М., Панкратьева А.Ю., et al. Динамика смертности от злокачественных новообразований, регистрируемых в ходе диспансеризации отдельных групп взрослого населения: популяционное исследование по данным архангельского областного канцер-регистра. Research'n Practical Medicine Journal. 2020; 7(4): 175-182.-DOI: 10.17709/2409-2231-2020-7-4-14. [Valkova L.E., Levit M.L., Merabishvili V.M., et al. Cancer mortality trends after implementation of the national programme for dispensarization of certain groups of the adult population: a population-based study from Arkhangelsk, North-Western Russia. Res Pract Med J. 2020; 7(4): 175-82.-DOI: 10.17709/2409-2231-2020-7-4-14 (In Rus)].
Zaorsky N.G., Churilla T.M., Egleston B.L., et al. Causes of death among cancer patients. Ann Oncol. 2017; 28(2): 400-7.-DOI: 10.1093/annonc/mdw604.
Вальков М.Ю., Карпунов А.А., Коулман М.П., et al. Популяционный раковый регистр как ресурс для науки и практического здравоохранения. Экология человека. 2017; 24(5): 54-62.-DOI: 10.33396/1728-0869-2017-5-54-62. [Valkov M.Yu., Karpunov A.A., Coleman M.P., et al. The population-based cancer registry as a resource for research and practical healthcare. Hum Ecol. 2017; 24(5): 54-62.-DOI: 10.33396/1728-0869-2017-5-54-62 (In Rus)].
Allemani C., Matsuda T., Di Carlo V., et al. Global surveillance of trends in cancer survival 2000-14 (CONCORD-3): analysis of individual records for 37,513,025 patients diagnosed with one of 18 cancers from 322 population-based registries in 71 countries. Lancet. 2018; 391(10125): 1023-75.-DOI: 10.1016/S0140-6736(17)33326-3.
Barchuk A., Tursun-Zade R., Nazarova E., et al. Completeness of regional cancer registry data in Northwest Russia 2008-2017. BMC Cancer. 2023; 23(1): 994.-DOI: 10.1186/s12885-023-11492-z.
Bray F., Colombet M., Aitken J.F., et al., editors. Cancer incidence in five continents, Vol. XII. Lyon: IARC. 2023. (IARC CancerBase No. 19).-URL: https://ci5.iarc.who.int (2024 Sep 29).
Рождаемость, смертность и естественный прирост населения. Управление Федеральной службы государственной статистики по Архангельской области и Ненецкому автономному округу. Интернет-ресурс.-URL: https://29.rosstat.gov.ru/population11 (09.14.2024). [Federal State Statistics Service. Fertility, mortality and natural population growth. Arkhangelsk: Rosstat. 2024.-URL: https://29.rosstat.gov.ru/population11 (09.14.2024) (In Rus)].
Koepsell T.D., Weiss N.S. Epidemiologic methods: studying the occurrence of illness. New York: Oxford University Press; 2003.-ISBN 0199387788, 9780199387786.
Dean A.G., Sullivan K.M., Soe M.M. OpenEpi: open source epidemiologic statistics for public health. 2013.-URL: http://www.OpenEpi.com (2024 Nov 7).
Koene R.J., Prizment A.E., Blaes A., Konety S.H. Shared risk factors in cardiovascular disease and cancer. Circulation. 2016; 133(11): 1104-14.-DOI: 10.1161/CIRCULATIONAHA.115.020406.
Yang P., Zheng Y., Chen .J, et al. Immediate risk of non-cancer deaths after a cancer diagnosis. BMC Cancer. 2021; 21(1): 963.-DOI: 10.1186/s12885-021-08707-6.
Strongman H., Gadd S., Matthews A., et al. Medium and long-term risks of specific cardiovascular diseases in survivors of 20 adult cancers: a population-based cohort study using multiple linked UK electronic health records databases. Lancet. 2019; 394(10203): 1041-54.-DOI: 10.1016/S0140-6736(19)31674-5.
Sturgeon K.M., Deng L., Bluethmann S.M., et al. A population-based study of cardiovascular disease mortality risk in US cancer patients. Eur Heart J. 2019; 40(48): 3889-97.-DOI: 10.1093/eurheartj/ehz766.
Herrmann J. Adverse cardiac effects of cancer therapies: cardiotoxicity and arrhythmia. Nat Rev Cardiol. 2020; 17(8): 474-502.-DOI: 10.1038/s41569-020-0348-1.
Jerusalem G., Lancellotti P., Kim S.B. HER2+ breast cancer treatment and cardiotoxicity: monitoring and management. Breast Cancer Res Treat. 2019; 177(2): 237-50.-DOI: 10.1007/s10549-019-05303-y.
Wu B.B., Leung K.T., Poon E.N. Mitochondrial-targeted therapy for doxorubicin-induced cardiotoxicity. Int J Mol Sci. 2022; 23(3): 1912.-DOI: 10.3390/ijms23031912.
Vater L.B., Lefebvre B., Turk A., Clasen S.C. Fluoropyrimidine cardiotoxicity: incidence, outcomes, and safety of rechallenge. Curr Oncol Rep. 2022; 24(7): 943-50.-DOI: 10.1007/s11912-022-01256-6.
Pai V.B., Nahata M.C. Cardiotoxicity of chemotherapeutic agents: incidence, treatment and prevention. Drug Saf. 2000; 22(4): 263-302.-DOI: 10.2165/00002018-200022040-00002.
Padegimas A., Clasen S., Ky B. Cardioprotective strategies to prevent breast cancer therapy-induced cardiotoxicity. Trends Cardiovasc Med. 2020; 30(1): 22-8.-DOI: 10.1016/j.tcm.2019.01.006.
Gao F., Xu T., Zang F., et al. Cardiotoxicity of anticancer drugs: molecular mechanisms, clinical management and innovative treatment. Drug Des Devel Ther. 2024; 18: 4089-116.-DOI: 10.2147/DDDT.S469331.
Mani K.A., Wu X., Spratt D.E., et al. A population-based study of COVID-19 mortality risk in US cancer patients. J Natl Cancer Inst. 2024; 116(8): 1288-93.-DOI: 10.1093/jnci/djae086.
Han Y., Li N., Zhang Y., et al. Epidemiology and risk factors for adult gliomas died by respiratory diseases during the COVID-19 pandemic: a population-based study. Neurosurg Rev. 2024; 47(1): 700.-DOI: 10.1007/s10143-024-02943-7.
Инструкция по применению Гам-КОВИД-Вак. Комбинированная векторная вакцина для профилактики коронавирусной инфекции, вызываемой вирусом SARS-CoV-2.-URL: https://www.vidal.ru/drugs/gam-covid-vac?ysclid=m762rfhjtf27224802 (15.02.2025). [Ministry of Health of the Russian Federation. Instructions for use Gam-COVID-Vac Combined vector vaccine for the prevention of coronavirus infection caused by the SARS-CoV-2 virus. 2025.-URL: https://www.vidal.ru/drugs/gam-covid-vac?ysclid=m762rfhjtf27224802 (15.02.2025) (In Rus)].
U.S. Food and Drug Administration. Artificial Intelligence and Machine Learning (AI/ML)-Enabled Medical Devices. Silver Spring: FDA; 2024.-URL: https://www.fda.gov/medical-devices/software-medical-device-samd/artificial-intelligence-and-machine-learning-aiml-enabled-medical-devices (2024 Dec 27).
Вальков М.Ю., Гржибовский А.М., Кудрявцев А.В., Гомболевский В.А., et al. Использование искусственного интеллекта для прогнозирования и предотвращении неонкологической смертности у онкологических больных: протокол исследования АРИЛИС. Экология человека. 2024; 31(4).-DOI: 10.17816/humeco635357. [Valkov M.Yu., Grjibovsky A.M., Kudryavtsev A.V., et al. Utilizing artificial intelligence to predict and prevent non-oncological mortality in cancer patients: the ARILUS study protocol. Hum Ecol. 2024; 31(4).-DOI: 10.17816/humeco635357 (In Rus)].
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