Table 1. COPD mortality among patients diagnosed with cancer between 1975 and 2016 in SEER 18 registries by baseline characteristics.
| Characteristics | No. of patients with cancer (%) | Person-years of follow-up | Death from COPD | SMR* (95% CI) | ||||
| Patients with cancer | General population | |||||||
| No. of observed COPD deaths (%) | Mortality | No. of Expected COPD deaths (%) | Mortality | |||||
| All | 7,846,370 (100%) | 45,601,152 | 119,228 (100%) | 261.5 | 54,955 | 120.5 | 2.17 (2.16–2.18) |
|
| Age | ||||||||
| 40–59 | 2,519,598 (32.1%) |
19,189,793 | 14,459 (12.1%) |
75.3 | 2,795 | 14.6 | 5.17 (5.09–5.26) |
|
| 60–79 | 4,165,541 (53.1%) |
23,176,048 | 79,553 (66.7%) |
343.3 | 35,821 | 154.6 | 2.22 (2.21–2.24) |
|
| 80+ | 1,161,231 (14.8%) |
3,235,312 | 25,216 (21.1%) |
779.4 | 16,339 | 505.0 | 1.54 (1.52–1.56) |
|
| Sex | ||||||||
| Female | 3,899,940 (49.7%) |
24,323,346 | 51,969 (43.6%) |
213.7 | 21,463 | 88.2 | 2.420 (2.40–2.44) |
|
| Male | 3,946,430 (50.3%) |
21,277,807 | 67,259 (56.4%) |
316.1 | 33,492 | 157.4 | 2.01 (1.99–2.02) |
|
| Race | ||||||||
| White | 6,531,177 (83.2%) |
38,835,087 | 108,069 (90.6%) | 278.3 | 50,481 | 130.0 | 2.14 (2.13–2.15) |
|
| Black | 795,400 (10.1%) |
3,889,420 | 7,426 (6.2%) | 190.9 | 3,085 | 79.3 | 2.41 (2.35–2.46) |
|
| Other | 519,793 (6.6%) |
2,876,646 | 3,733 (3.1%) |
129.8 | 1,389 | 48.3 | 2.69 (2.60–2.78) |
|
| Year | ||||||||
| 1975–1989 | 1,015,383 (12.9%) |
8,110,919 | 23,883 (20.0%) |
294.5 | 7,218 | 89.0 | 3.31 (3.27–3.35) |
|
| 1990–1999 | 1,213,899 (15.5%) |
10,580,651 | 29,878 (25.1%) |
282.4 | 12,979 | 122.7 | 2.30 (2.28–2.33) |
|
| 2000–2009 | 3,181,105 (40.5%) |
21,014,768 | 51,214 (43.0%) |
243.7 | 26,925 | 128.1 | 1.90 (1.89–1.92) |
|
| 2010–2016 | 2,435,983 (31.0%) |
5,894,814 | 14,253 (12.0%) |
241.8 | 7,833 | 132.9 | 1.82 (1.79–1.85) |
|
| Marital status | ||||||||
| Married | 4,428,425 (56.4%) |
28,888,368 | 60,504 (50.7%) |
209.4 | 32,318 | 111.9 | 1.87 (1.86–1.89) |
|
| Unmarried | 2,862,961 (36.5%) |
13,449,450 | 50,655 (42.5%) |
376.6 | 18,097 | 134.6 | 2.80 (2.77–2.82) |
|
| Unknown | 554,984 (7.1%) |
3,263,335 | 8,069 (6.8%) |
247.3 | 4,540 | 139.1 | 1.78 (1.74–1.82) |
|
| Stage | ||||||||
| In situ | 447,307 (5.7%) |
4,136,939 | 5,942 (5.0%) |
143.6 | 3,836 | 92.7 | 1.55 (1.51–1.59) |
|
| Localized | 2,938,939 (37.5%) |
24,566,825 | 56,065 (47.0%) |
228.2 | 29,528 | 120.2 | 1.90 (1.88–1.91) |
|
| Regional | 1,291,329 (16.5%) |
7,318,490 | 19,633 (16.5%) |
268.3 | 7,400 | 101.1 | 2.65 (2.62–2.69) |
|
| Distant | 1,376,743 (17.5%) |
2,725,893 | 10,987 (9.2%) |
403.1 | 3,475 | 127.5 | 3.16 (3.10–3.22) |
|
| Unstaged | 1,792,052 (22.8%) |
6,853,006 | 26,601 (22.3%) |
388.2 | 10,716 | 156.4 | 2.48 (2.45–2.51) |
|
| Surgery | ||||||||
| Yes | 4,627,898 (59.0%) |
35,043,784 | 71,451 (59.9%) |
203.9 | 36,740 | 104.8 | 1.94 (1.93–1.96) |
|
| No | 3,096,678 (39.5%) |
10,147,592 | 46,310 (38.8%) |
456.4 | 17,664 | 174.1 | 2.62 (2.60–2.65) |
|
| Unknown | 121,794 (1.6%) |
409,777 | 1,467 (1.2%) |
358.0 | 551 | 134.5 | 2.66 (2.53–2.80) |
|
| Chemotherapy | ||||||||
| Yes | 1,913,324 (24.4%) |
8,070,822 | 13,749 (11.5%) |
170.4 | 6,442 | 79.8 | 2.13 (2.10–2.17) |
|
| No/Unknown | 5,933,046 (75.6%) |
37,530,330 | 105,479 (88.5%) |
281.1 | 48,513 | 129.3 | 2.17 (2.16–2.19) |
|
| Radiotherapy | ||||||||
| Yes | 2,147,710 (27.4%) |
12,695,889 | 27,279 (22.9%) |
214.9 | 13,735 | 108.2 | 1.99 (1.96–2.01) |
|
| No/unknown | 5,698,660 (72.6%) |
32,905,263 | 91,949 (77.1%) |
279.4 | 41,220 | 125.3 | 2.23 (2.22–2.25) |
|
| Smoking prevalence | ||||||||
| Low | 1,308,905 (16.7%) |
8,406,893 | 17,316 (14.5%) |
206.0 | 10,599 | 126.1 | 1.63 (1.61–1.66) |
|
| Median | 1,308,906 (16.7%) |
9,119,074 | 21,469 (18.0%) |
235.4 | 11,513 | 126.3 | 1.86 (1.84–1.89) |
|
| High | 1,308,906 (16.7%) |
8,433,315 | 24,940 (20.9%) |
295.7 | 10,969 | 130.1 | 2.27 (2.25–2.30) |
|
| Unknown | 3,919,653 (50.0%) |
19,641,871 | 55,503 (46.6%) |
282.6 | 21,874 | 111.4 | 2.54 (2.52–2.56) |
|
| SES | ||||||||
| Low | 2,276,448 (29.0%) |
10,011,552 | 31,310 (26.3%) |
312.7 | 13,472 | 134.6 | 2.32 (2.30–2.35) |
|
| Median | 2,276,449 (29.0%) |
13,393,773 | 34,245 (28.7%) |
255.7 | 17,115 | 127.8 | 2.00 (1.98–2.02) |
|
| High | 2,276,450 (29.0%) |
14,074,860 | 29,766 (25.0%) |
211.5 | 17,136 | 121.7 | 1.74 (1.72–1.76) |
|
| Unknown | 1,017,023 (13.0%) |
8,120,968 | 23,907 (20.1%) |
294.4 | 7,232 | 89.1 | 3.31 (3.26–3.35) |
|
Abbreviations: COPD, chronic obstructive pulmonary disease; SMR, standardized mortality ratios; CI, confidence interval; SES, socioeconomic status.
*The SMRs were estimated as the ratios of observed to expected number of deaths. The observed values represented the number of COPD deaths in cancer patients, whereas the expected values represented the number of individuals who died of COPD in the general population, with a similar distribution of age, sex, race, and calendar year.