Non-cancer mortality among long-term survivors of adult cancer in Korea: national cancer registry study.
OBJECTIVE
To investigate the pattern of non-cancer deaths and to determine whether there is excess mortality from non-cancer causes among Korean long-term survivors of adult cancer.


METHODS
We merged national cancer registry data and national death registration data to determine non-cancer death patterns of 243,713 people who were diagnosed with cancer from 1993 to 2000 and who survived > or =5 years. We calculated standardized mortality ratios (SMRs) by an indirect standardization method.


RESULTS
Of the patient population, 26,498 (10.9%) had died as of December 2005; the cause of death for 6,364 (24.0%) of those was not cancer. The proportion of non-cancer mortality increased with age at diagnosis and correlated with the 5-year survival rate (r = 0.336 for women, 0.571 for men). Although the risk for non-cancer death was lower among long-term survivors in general (SMR, 0.78; 95% CI, 0.76-0.80), it was higher among younger survivors (SMR, 1.23-2.50, for those who died before 50) than the general population. Survivors had an elevated suicide rate (SMR, 1.28; 95% CI, 1.15-1.42), especially male (SMR, 1.35; 95% CI, 1.19-1.53) and stomach cancer survivors (SMR, 1.38; 95% CI, 1.14-1.66).


CONCLUSIONS
Appropriate medical attention for long-term adult cancer survivors, especially younger survivors, is warranted to prevent premature deaths from non-cancer causes.
Shin
Dong Wook
DW
National Cancer Control Institute (NCCI) and Hospital, National Cancer Center, 323 Ilsanro, Ilsan dong-gu, Goyang-si, Gyeonggi-do, 411-769, Korea.
Ahn
Eunmi
E
Kim
Hyerim
H
Park
Sohee
S
Kim
Young Ae
YA
Yun
Young Ho
YH
D000328:Adult; D003625:Data Collection; D005260:Female; D006801:Humans; D007723:Korea; D008297:Male; D009369:Neoplasms / Q000401:mortality*; D009423:Nervous System Neoplasms / Q000401:mortality; D010361:Patients; D012042:Registries; D012307:Risk Factors; D015996:Survival Rate; D017741:Survivors / Q000706:statistics & numerical data*