Open AccessAssociation of age and cause-special mortality in patients with stage I/ II colon cancer: A population-based competing risk analysis
Author(s) -
Huajun Cai,
Yiyi Zhang,
Xing Liu,
Weizhong Jiang,
Zhifen Chen,
Shoufeng Li,
Guoxian Guan
Publication year - 2020
Publication title -
plos one
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.99
H-Index - 332
ISSN - 1932-6203
DOI - 10.1371/journal.pone.0240715
Subject(s) - incidence (geometry) , colorectal cancer , cumulative incidence , confidence interval , epidemiology , medicine , cancer , stage (stratigraphy) , oncology , demography , biology , cohort , paleontology , sociology , physics , optics
Purpose This study aimed to determine the probability and prognostic factors of colon cancer-specific mortality (CCSM) and noncancer-specific mortality (NCSM) for patients with stage I/II colon cancer and evaluate the association of age on cause-specific mortality. Materials and methods From Surveillance, Epidemiology, and End Results (SEER) database, we identified 33152 patients with stage I/II colon cancer undergoing surgery between 2004 and 2011. The cumulative incidence of CCSM and NCSM was calculated, and competing risk analysis was performed to investigate prognostic factors for cause-specific mortality. Results In patients <50, 50–75, and >75 years of age, 5-year cumulative incidence of CCSM was 5.7%, 7.8%, and 16.1%, respectively (overall, 10.6%); 5-year cumulative incidence of NCSM was 2.2%, 7.1%, and 26.9%, respectively (overall, 13.8%). The probability of CCSM and NCSM increased with advanced age. The 5-year cumulative incidence of CCSM was higher than NCSM in patients <50 years of age, whereas lower in patients >75 years of age. The probability of CCSM and NCSM was similar in patients 50–75 years of age. Competing-risk multivariable analysis demonstrated that increasing age was a strong predictor of CCSM (per year increase, SHR 1.03,95% confidence interval [CI]: 1.03–1.04). Age was most predictive of NCSM: (per year increase, SHR 1.08, 95% CI: 1.08–1.08). Conclusion Age was significantly associated with an increased cumulative incidence of CCSM and NCSM of patients with stage I/II colon cancer underwent surgery. NCSM was a significant competing event and should be adequately considered when performing survival analysis.