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Long-Term Cardiovascular Mortality among 80,042 Older Patients with Bladder Cancer

SIMPLE SUMMARY: We conducted a large-scale population-based study with long-term follow-up to obtain a comprehensive assessment of death causes, especially cardiovascular disease death, among 80,042 older bladder cancer patients from a national cancer registry containing 44 years of data. To our kno...

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Autores principales: Guan, Tianwang, Su, Miao, Luo, Zehao, Peng, Weien, Zhou, Ruoyun, Lu, Zhenxing, Feng, Manting, Li, Weirun, Teng, Yintong, Jiang, Yanting, Ou, Caiwen, Chen, Minsheng
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9559628/
https://www.ncbi.nlm.nih.gov/pubmed/36230496
http://dx.doi.org/10.3390/cancers14194572
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author Guan, Tianwang
Su, Miao
Luo, Zehao
Peng, Weien
Zhou, Ruoyun
Lu, Zhenxing
Feng, Manting
Li, Weirun
Teng, Yintong
Jiang, Yanting
Ou, Caiwen
Chen, Minsheng
author_facet Guan, Tianwang
Su, Miao
Luo, Zehao
Peng, Weien
Zhou, Ruoyun
Lu, Zhenxing
Feng, Manting
Li, Weirun
Teng, Yintong
Jiang, Yanting
Ou, Caiwen
Chen, Minsheng
author_sort Guan, Tianwang
collection PubMed
description SIMPLE SUMMARY: We conducted a large-scale population-based study with long-term follow-up to obtain a comprehensive assessment of death causes, especially cardiovascular disease death, among 80,042 older bladder cancer patients from a national cancer registry containing 44 years of data. To our knowledge, this was the first study to report the importance of CVD-related death as a competing risk among older patients with bladder cancer. CVD-related death surpassed BC as the leading cause of death 5–10 years after diagnosis among older BC patients, especially for patients with localized-stage and low-grade tumors. Furthermore, older BC patients had a higher risk of CVD-related death than the general population. Although BC management should be the primary focus of older BC patients, our results emphasized the importance of competing risks, the most prominent being CVD. Individual follow-up and management should focus not only on primary cancer but also on CVD-related death to minimize the risk of death in older patients with bladder cancer. ABSTRACT: Background: To identify the risk of death from cardiovascular disease (CVD) in older patients with bladder cancer (BC). Methods: This population-based study included 80,042 older BC patients (≥65 years) diagnosed between 1975 and 2018, with a mean follow-up of 17.2 years. The proportion of deaths, competing risk models, standardized mortality ratio (SMR), and absolute excess risk (AER) per 10,000 person-years were applied to identify the risk of CVD-related deaths among older BC patients. Results: For older patients with BC, CVD-related death was the chief cause of death, and cumulative CVD-related mortality also exceeded primary BC as the leading cause of death mostly 5–10 years after BC diagnosis, especially in localized-stage and low-grade subgroups. The risk of short- and long-term CVD-related death in older BC patients was higher than in the general older adult population (SMR = 1.30, 95% CI 1.28–1.32; AER = 105.68). The risk of sex-specific CVD-related deaths also increased compared to the general population of older adults, including heart disease, cerebrovascular diseases, hypertension without heart disease, atherosclerosis, aortic aneurysm and dissection, and other diseases of the arteries, arterioles, and capillaries. Conclusions: CVD-related death is an important competing risk among older BC patients and has surpassed primary BC as the chief cause of death, mainly 5–10 years after BC diagnosis. The risk of CVD-related death in older patients with BC was greater than in the general population. The management of older patients with BC should focus not only on the primary cancer but also on CVD-related death.
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spelling pubmed-95596282022-10-14 Long-Term Cardiovascular Mortality among 80,042 Older Patients with Bladder Cancer Guan, Tianwang Su, Miao Luo, Zehao Peng, Weien Zhou, Ruoyun Lu, Zhenxing Feng, Manting Li, Weirun Teng, Yintong Jiang, Yanting Ou, Caiwen Chen, Minsheng Cancers (Basel) Article SIMPLE SUMMARY: We conducted a large-scale population-based study with long-term follow-up to obtain a comprehensive assessment of death causes, especially cardiovascular disease death, among 80,042 older bladder cancer patients from a national cancer registry containing 44 years of data. To our knowledge, this was the first study to report the importance of CVD-related death as a competing risk among older patients with bladder cancer. CVD-related death surpassed BC as the leading cause of death 5–10 years after diagnosis among older BC patients, especially for patients with localized-stage and low-grade tumors. Furthermore, older BC patients had a higher risk of CVD-related death than the general population. Although BC management should be the primary focus of older BC patients, our results emphasized the importance of competing risks, the most prominent being CVD. Individual follow-up and management should focus not only on primary cancer but also on CVD-related death to minimize the risk of death in older patients with bladder cancer. ABSTRACT: Background: To identify the risk of death from cardiovascular disease (CVD) in older patients with bladder cancer (BC). Methods: This population-based study included 80,042 older BC patients (≥65 years) diagnosed between 1975 and 2018, with a mean follow-up of 17.2 years. The proportion of deaths, competing risk models, standardized mortality ratio (SMR), and absolute excess risk (AER) per 10,000 person-years were applied to identify the risk of CVD-related deaths among older BC patients. Results: For older patients with BC, CVD-related death was the chief cause of death, and cumulative CVD-related mortality also exceeded primary BC as the leading cause of death mostly 5–10 years after BC diagnosis, especially in localized-stage and low-grade subgroups. The risk of short- and long-term CVD-related death in older BC patients was higher than in the general older adult population (SMR = 1.30, 95% CI 1.28–1.32; AER = 105.68). The risk of sex-specific CVD-related deaths also increased compared to the general population of older adults, including heart disease, cerebrovascular diseases, hypertension without heart disease, atherosclerosis, aortic aneurysm and dissection, and other diseases of the arteries, arterioles, and capillaries. Conclusions: CVD-related death is an important competing risk among older BC patients and has surpassed primary BC as the chief cause of death, mainly 5–10 years after BC diagnosis. The risk of CVD-related death in older patients with BC was greater than in the general population. The management of older patients with BC should focus not only on the primary cancer but also on CVD-related death. MDPI 2022-09-21 /pmc/articles/PMC9559628/ /pubmed/36230496 http://dx.doi.org/10.3390/cancers14194572 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Guan, Tianwang
Su, Miao
Luo, Zehao
Peng, Weien
Zhou, Ruoyun
Lu, Zhenxing
Feng, Manting
Li, Weirun
Teng, Yintong
Jiang, Yanting
Ou, Caiwen
Chen, Minsheng
Long-Term Cardiovascular Mortality among 80,042 Older Patients with Bladder Cancer
title Long-Term Cardiovascular Mortality among 80,042 Older Patients with Bladder Cancer
title_full Long-Term Cardiovascular Mortality among 80,042 Older Patients with Bladder Cancer
title_fullStr Long-Term Cardiovascular Mortality among 80,042 Older Patients with Bladder Cancer
title_full_unstemmed Long-Term Cardiovascular Mortality among 80,042 Older Patients with Bladder Cancer
title_short Long-Term Cardiovascular Mortality among 80,042 Older Patients with Bladder Cancer
title_sort long-term cardiovascular mortality among 80,042 older patients with bladder cancer
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9559628/
https://www.ncbi.nlm.nih.gov/pubmed/36230496
http://dx.doi.org/10.3390/cancers14194572
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