Competing risks of cancer mortality and cardiovascular events in individuals with multimorbidity

Journal of Comorbidity
Elizabeth A BaylissJohn F Steiner

Abstract

Cancer patients with cardiovascular and other comorbidities are at concurrent risk of multiple adverse outcomes. However, most treatment decisions are guided by evidence from single-outcome models, which may be misleading for multimorbid patients. We assessed the interacting effects of cancer, cardiovascular, and other morbidity burdens on the competing outcomes of cancer mortality, serious cardiovascular events, and other-cause mortality. We analyzed a cohort of 6,500 adults with initial cancer diagnosis between 2001 and 2008, SEER 5-year survival ≥26%, and a range of cardiovascular risk factors. We estimated the cumulative incidence of cancer mortality, a serious cardiovascular event (myocardial infarction, coronary revascularization, or cardiovascular mortality), and other-cause mortality over 5 years, and identified factors associated with the competing risks of each outcome using cause-specific Cox proportional hazard models. Following cancer diagnosis, there were 996 (15.3%) cancer deaths, 328 (5.1%) serious cardiovascular events, and 542 (8.3%) deaths from other causes. In all, 4,634 (71.3%) cohort members had none of these outcomes. Although cancer prognosis had the greatest effect, cardiovascular and other morbidity al...Continue Reading

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Citations

Feb 5, 2019·Cardiovascular Research·Wouter C Meijers, Rudolf A de Boer
Feb 1, 2019·Journal of Epidemiology and Community Health·Enrique RegidorPaloma Ortega
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Dec 7, 2018·JAMA Internal Medicine·Ming Zhou, Zhen Zhou
Nov 14, 2018·Cancer Causes & Control : CCC·Rhonda ArthurMieke Van Hemelrijck

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Software Mentioned

Cancer Survival Query System
Statistical Analysis System ( SAS )

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