Table 1.
Infectious mortality among patients diagnosed with cancer between 1975 and 2016 in SEER 18 registries by baseline characteristics
| Characteristics | No. of patients with cancer (%) | Total person years of follow-up | Death from infectious diseases | SMRb (95% CI) | |||
|---|---|---|---|---|---|---|---|
| Patients with cancer | General population | ||||||
| No. of observed deathsa (%) | Mortality rates (per 100,000 person-years) | No. of expected deathsa (%) | Mortality rates (per 100,000 person-years) | ||||
| All patients | 8,471,051 (100%) | 51,727,359 | 134,526 (100%) | 260.1 | 46,009.9 | 88.9 | 2.92 (2.91–2.94) |
| Age | |||||||
| 0–19 | 107,868 (1.3%) | 1,057,133 | 486 (0.4%) | 46.0 | 37.8 | 3.6 | 12.9 (11.8–14.1) |
| 20–39 | 516,813 (6.1%) | 5,088,379 | 13,437 (10.0%) | 264.1 | 517.1 | 10.2 | 26.0 (25.6–26.4) |
| 40–59 | 2,519,598 (29.7%) | 19,186,562 | 27,930 (20.8%) | 145.6 | 4,898.1 | 25.5 | 5.70 (5.64–5.77) |
| 60–79 | 4,165,541 (49.2%) | 23,166,272 | 62,661 (46.6%) | 270.5 | 22,059.1 | 95.2 | 2.84 (2.82–2.86) |
| 80+ | 1,161,231 (13.7%) | 3,229,012 | 30,012 (22.3%) | 929.4 | 18,497.8 | 572.9 | 1.62 (1.60–1.64) |
| Sex | |||||||
| Female | 4,268,625 (50.4%) | 28,108,519 | 50,049 (37.2%) | 178.1 | 18,936.1 | 67.4 | 2.64 (2.62–2.67) |
| Male | 4,202,426 (49.6%) | 23,618,840 | 84,477 (62.8%) | 357.7 | 27,073.8 | 114.6 | 3.12 (3.10–3.14) |
| Race | |||||||
| White | 7,036,840 (83.1%) | 43,981,395 | 108,727 (80.8%) | 247.2 | 38,020.4 | 86.4 | 2.86 (2.84–2.88) |
| Black | 861,518 (10.2%) | 4,420,987 | 17,919 (13.3%) | 405.3 | 5,826.4 | 131.8 | 3.08 (3.03–3.12) |
| Other | 572,693 (6.8%) | 3,324,977 | 7,880 (5.9%) | 237.0 | 2,163.1 | 65.1 | 3.64 (3.56–3.72) |
| Year | |||||||
| 1975–1989 | 1,104,822 (13.0%) | 9,922,591 | 32,033 (23.8%) | 322.8 | 7,349.2 | 74.1 | 4.36 (4.31–4.41) |
| 1990–1999 | 1,319,905 (15.6%) | 12,137,240 | 39,184 (29.1%) | 322.8 | 12,141.4 | 100.0 | 3.23 (3.20–3.26) |
| 2000–2009 | 3,422,077 (40.4%) | 23,242,380 | 47,143 (35.0%) | 202.8 | 20,834.1 | 89.6 | 2.26 (2.24–2.28) |
| 2010–2016 | 2,624,247 (31.0%) | 6,425,148 | 16,166 (12.0%) | 251.6 | 5,685.2 | 88.5 | 2.84 (2.80–2.89) |
| Marital status | |||||||
| Married | 4,679,040 (55.2%) | 31,615,761 | 57,391 (42.7%) | 181.5 | 24,746.3 | 78.3 | 2.32 (2.30–2.34) |
| Unmarried | 3,194,607 (37.7%) | 16,437,775 | 68,462 (50.9%) | 416.5 | 17,557.0 | 106.8 | 3.90 (3.87–3.93) |
| Unknown | 597,404 (7.1%) | 3,673,824 | 8,673 (6.4%) | 236.1 | 3,706.6 | 100.9 | 2.34 (2.29–2.39) |
| Stage | |||||||
| In situ | 483,079 (5.7%) | 4,577,177 | 5,626 (4.2%) | 122.9 | 3,024.8 | 66.1 | 1.86 (1.81–1.91) |
| Localized | 3,144,583 (37.1%) | 27,221,996 | 45,891 (34.1%) | 168.6 | 24,056.8 | 88.4 | 1.91 (1.89–1.93) |
| Regional | 1,391,229 (16.4%) | 8,313,131 | 19,270 (14.3%) | 231.8 | 6,592.7 | 79.3 | 2.92 (2.88–2.96) |
| Distant | 1,463,749 (17.3%) | 3,301,674 | 14,155 (10.5%) | 428.7 | 2,980.7 | 90.3 | 4.75 (4.67–4.83) |
| Unstaged | 1,988,411 (23.5%) | 8,313,382 | 49,584 (36.9%) | 596.4 | 9,354.9 | 112.5 | 5.30 (5.25–5.35) |
| Surgery | |||||||
| Yes | 5,067,632 (59.8%) | 39,847,230 | 69,617 (51.7%) | 174.7 | 31,021.5 | 77.9 | 2.24 (2.23–2.26) |
| No | 3,274,257 (38.7%) | 11,392,253 | 62,729 (46.6%) | 550.6 | 14,498.8 | 127.3 | 4.33 (4.29–4.36) |
| Unknown | 129,162 (1.5%) | 487,876 | 2,180 (1.6%) | 446.8 | 489.5 | 100.3 | 4.45 (4.27–4.64) |
| Chemotherapy | |||||||
| Yes | 2,152,975 (25.4%) | 9,962,269 | 26,589 (19.8%) | 266.9 | 5,244.5 | 52.6 | 5.07 (5.01–5.13) |
| No/unknown | 6,318,076 (74.6%) | 41,765,090 | 107,937 (80.2%) | 258.4 | 40,765.4 | 97.6 | 2.65 (2.63–2.66) |
| Radiotherapy | |||||||
| Yes | 2,316,329 (27.3%) | 14,343,406 | 28,703 (21.3%) | 200.1 | 10,539.6 | 73.5 | 2.72 (2.69–2.76) |
| No/unknown | 6,154,722 (72.7%) | 37,383,953 | 105,823 (78.7%) | 283.1 | 35,470.3 | 94.9 | 2.98 (2.97–3.00) |
| Cause | |||||||
| Pneumonia and influenza | 8,471,051 (100%) | 51,727,359 | 61,773 (45.9%) | 25,999.3 | 119.4 | 50.2 | 2.38 (2.36–2.39) |
| Tuberculosis | 8,471,051 (100%) | 51,727,359 | 711 (0.5%) | 527.9 | 1.37 | 1.02 | 1.35 (1.25–1.45) |
| Syphilis | 8,471,051 (100%) | 51,727,359 | 27 (0.02%) | 15.6 | 0.05 | 0.03 | 1.73 (1.19–2.53) |
| Septicemia | 8,471,051 (100%) | 51,727,359 | 28,765 (21.4%) | 11,571.6 | 55.6 | 22.4 | 2.49 (2.46–2.51) |
| Other infectious and parasitic diseases including HIV | 8,471,051 (100%) | 51,727,359 | 43,250 (32.1%) | 5,559.8 | 83.6 | 10.7 | 7.78 (7.71–7.85) |
SMR standardized mortality ratios; CI confidence interval; HIV human immunodeficiency virus
aObserved deaths represent the total number of deaths from fatal infections among patients with cancer recorded during the study period. Expected deaths represent the number of individuals who died of fatal infections in the general population with a similar distribution of age at diagnosis, sex, race, and calendar year
bThe SMRs were estimated as the ratios of observed to expected number of deaths. The observed values represented the number of deaths in cancer patients, whereas the expected values represented the number of individuals who died of the same causes in the general population, with a similar distribution of age, sex, race, and calendar year