Top Causes of Early Noncancer Deaths in Advanced GU Cancers

TOPLINE:

Adults diagnosed with metastatic genitourinary cancers face an increased risk for early death due to sepsis, cardiovascular disease (CVD), and other noncancer causes, new research showed.

METHODOLOGY:

• Researchers used Surveillance, Epidemiology, and End Results data (2004-2020) to investigate noncancer causes of death in 77,246 adults with metastatic genitourinary cancers, which included bladder, kidney, and prostate cancer.
• The researchers calculated standardized mortality ratios (SMRs) for noncancer deaths within 2 years of first metastatic genitourinary diagnosis. SMR was defined as “observed deaths from each category divided by the expected number of deaths in the age-matched US population for the same period.”
• The results were stratified by age, race, ethnicity, chemotherapy, and marital status.

TAKEAWAY:

• Sepsis was the leading cause of early noncancer deaths across all genitourinary cancers (SMR, 4.21), followed by CVD (SMR, 1.70), kidney disease (SMR, 1.58), liver disease (SMR, 1.58), diabetes (SMR, 1.56), and respiratory disease (SMR, 1.38).
• Adults younger than 50 years had the highest risk for death from sepsis (SMR, 61.76), followed by kidney disease (SMR, 28.06) and CVD (SMR, 5.63). Adults aged 50-70 years were also more likely to die from sepsis (SMR, 8.7), kidney disease (SMR, 3.55), and CVD (SMR, 3.24).
• The results were largely consistent in Black patients, who had a higher risk for death due to sepsis (SMR, 6.59), followed by CVD (SMR, 2.01), respiratory (SMR, 2.01), and kidney (SMR, 1.64) diseases. Asian/Pacific Islanders were more likely to die from sepsis (SMR, 4.35) and CVD (SMR, 2.52), non-Hispanic patients from sepsis as well (SMR, 4.28), and Hispanic patients from sepsis (SMR, 3.58) and liver disease (SMR, 3.11).
• The risk for death due to sepsis was higher among patients receiving chemotherapy (SMR, 7.06) vs not receiving chemotherapy (SMR, 3.71) and in adults who were single, widowed, or divorced (SMR, 4.44) vs married (SMR, 4.04).

IN PRACTICE:

In this study, “sepsis remained the leading cause of early noncancer deaths” in metastatic genitourinary cancers across all subgroups, the authors concluded.

SOURCE:

The study, with first author Ahsan Ayaz, MD, with Montefiore St. Luke’s Cornwall Hospital, Newburgh, New York, was presented in a poster at the 2024 American Society of Clinical Oncology Genitourinary Cancers Symposium.

LIMITATIONS:

The abstract did not list limitations.

DISCLOSURES:

The study had no specific funding. Ayaz had no disclosure.