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• W2280792020 abstract "Patients with head and neck squamous cell carcinoma (HNSCC) are at risk for death from causes related and unrelated to their cancer. The risk of death from noncancer causes is termed competing risk from the perspective of cancer treatment and research. These patients have been found to have elevated competing risks compared to the general population and other cancer populations, likely related to high rates of substance use and comorbidities. We aim to identify the sociodemographic and tumor characteristics that distinguish the group of HNSSC patients who die from their primary cancer to those that die of competing causes. Deceased adult patients with histologically proven, mucosal HNSCC diagnosed between 2004 and 2012 were identified from the Surveillance, Epidemiology and End Result database. Tumor characteristics, demographic variables, survival, and cause of death were collected. Patients with insufficient data, including unknown cause of death, and previous cancers were excluded. The competing causes of death for HNSCC are presented with comparisons to thyroid and salivary gland cancer patients and the general population. Standardized incidence ratios (SIR) are calculated to compare death rates between the HNSSC cohort and the general population. HNSSC patients who died of causes related to their primary tumor are then compared to those deceased from other causes using a chi-squared analysis. Of 64,598 patients meeting study criteria, 17,460 were deceased, including 29.0% from noncancer causes. The 5 most common causes of death not attributable to the primary tumor were cardiac (26.4%), COPD (8.8%), lung cancer (6.4%), other cancers (5.3%), and stroke (5.3%). These are also the 5 leading causes in a general population cohort matched for age, race, and gender. Excluding cancer-related mortality, the SIR was elevated among HNSCC patients for all causes of death (11.3); most drastically for chronic liver disease (38.4), suicide (36.1), and second HNSCC primaries (24.5). Compared to patients who died of their cancer, patients who died from competing causes are older and more often white with early-stage and laryngeal tumors (P<.001). As a group, HNSCC patients are at substantially increased risk of dying from all causes, not only their cancer. Compared to the general population, these patients have greatly elevated risk of dying from all causes, especially some rare causes like suicide. However, the majority of noncancer-related deaths in this group are attributable to causes also common in the general population, like cardiovascular disease and stroke. While treating patients with HNSCC for their cancer, screening and treatment of other risk factors should not be neglected, especially in those with curable cancers at risk for mortality from other causes." @default.
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• W2280792020 date "2016-03-01" @default.
• W2280792020 modified "2023-09-27" @default.
• W2280792020 title "Comparison of Head and Neck Cancer Populations by Cause of Death" @default.
• W2280792020 doi "https://doi.org/10.1016/j.ijrobp.2015.12.317" @default.
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