Causes of death in women with breast cancer: a risks and rates study on a population-based cohort.

Autor:	Contiero P; Environmental Epidemiology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy., Boffi R; Respiratory Disease Unit, Fondazione IRCCS Istituto Nazionale Tumori, Milan, Italy., Borgini A; Environmental Epidemiology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy., Fabiano S; Cancer Registry Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy., Tittarelli A; Cancer Registry Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy., Mian M; Innovation, Research and Teaching Service, Hospital of Bolzano (SABES-ASDAA), Teaching Hospital of the Paracelsus Medizinischen Privatuniversität (PMU), Bozen, Italy., Vittadello F; Explora, Research and Statistical Analysis, Padova, Italy., Epifani S; Statistics and Epidemiology Unit, ASL Brindisi, Brindisi, Italy., Ardizzone A; Statistics and Epidemiology Unit, ASL Brindisi, Brindisi, Italy., Cirilli C; Servizio di Epidemiologia e Comunicazione del Rischio-Unità Funzionale di Modena, Registro Tumori Regione, Modena, Italy., Boschetti L; Pavia Cancer Registry, Public Health Agency of Pavia, Pavia, Italy., Marguati S; Pavia Cancer Registry, Public Health Agency of Pavia, Pavia, Italy., Cascone G; Ragusa Cancer Registry Unit, Azienda Sanitaria Provinciale di Ragusa (ASP), Ragusa, Italy., Tumino R; Ragusa Cancer Registry Unit, Azienda Sanitaria Provinciale di Ragusa (ASP), Ragusa, Italy., Fanetti AC; ATS della Montagna, S.S. Epidemiologia, Sondrio, Italy., Giumelli P; ATS della Montagna, S.S. Epidemiologia, Sondrio, Italy., Candela G; Trapani and Agrigento Cancer Registry, Trapani, Italy., Scuderi T; Trapani and Agrigento Cancer Registry, Trapani, Italy., Castelli M; Dipartimento di Prevenzione Azienda USL Valle d'Aosta Loc, Quart, Italy., Bongiorno S; Dipartimento di Prevenzione Azienda USL Valle d'Aosta Loc, Quart, Italy., Barigelletti G; Cancer Registry Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy., Perotti V; Cancer Registry Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy., Veronese C; Respiratory Disease Unit, Fondazione IRCCS Istituto Nazionale Tumori, Milan, Italy., Turazza F; Cardiology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy., Crivaro M; Cardiology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy., Tagliabue G; Cancer Registry Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy.
Jazyk:	angličtina
Zdroj:	Frontiers in oncology [Front Oncol] 2023 Nov 01; Vol. 13, pp. 1270877. Date of Electronic Publication: 2023 Nov 01 (Print Publication: 2023).
DOI:	10.3389/fonc.2023.1270877
Abstrakt:	Introduction: The increasing survival of patients with breast cancer has prompted the assessment of mortality due to all causes of death in these patients. We estimated the absolute risks of death from different causes, useful for health-care planning and clinical prediction, as well as cause-specific hazards, useful for hypothesis generation on etiology and risk factors. Materials and Methods: Using data from population-based cancer registries we performed a retrospective study on a cohort of women diagnosed with primary breast cancer. We carried out a competing-cause analysis computing cumulative incidence functions (CIFs) and cause-specific hazards (CSHs) in the whole cohort, separately by age, stage and registry area. Results: The study cohort comprised 12,742 women followed up for six years. Breast cancer showed the highest CIF, 13.71%, and cardiovascular disease was the second leading cause of death with a CIF of 3.60%. The contribution of breast cancer deaths to the CIF for all causes varied widely by age class: 89.25% in women diagnosed at age <50 years, 72.94% in women diagnosed at age 50-69 and 48.25% in women diagnosed at age ≥70. Greater CIF variations were observed according to stage: the contribution of causes other than breast cancer to CIF for all causes was 73.4% in women with stage I disease, 42.9% in stage II-III and only 13.2% in stage IV. CSH computation revealed temporal variations: in women diagnosed at age ≥70 the CSH for breast cancer was equaled by that for cardiovascular disease and "other diseases" in the sixth year following diagnosis, and an early peak for breast cancer was identified in the first year following diagnosis. Among women aged 50-69 we identified an early peak for breast cancer followed by a further peak near the second year of follow-up. Comparison by geographic area highlighted conspicuous variations: the highest CIF for cardiovascular disease was more than 70% higher than the lowest, while for breast cancer the highest CIF doubled the lowest. Conclusion: The integrated interpretation of absolute risks and hazards suggests the need for multidisciplinary surveillance and prevention using community-based, holistic and well-coordinated survivorship care models. Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. (Copyright © 2023 Contiero, Boffi, Borgini, Fabiano, Tittarelli, Mian, Vittadello, Epifani, Ardizzone, Cirilli, Boschetti, Marguati, Cascone, Tumino, Fanetti, Giumelli, Candela, Scuderi, Castelli, Bongiorno, Barigelletti, Perotti, Veronese, Turazza, Crivaro, Tagliabue and the MAPACA Working Group.)
Databáze:	MEDLINE
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