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Patients with cancer face a significantly higher risk of death from infections, especially within the first year post-diagnosis. Older, male, Black, and unmarried individuals are most vulnerable, requiring targeted infection prevention strategies.

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Area of Science:

  • Oncology
  • Infectious Disease Epidemiology
  • Public Health

Background:

  • Infection mortality is a critical concern for patients living with cancer.
  • Early identification of high-risk individuals is essential for effective prevention strategies.

Purpose of the Study:

  • To characterize infection-specific mortality risk in a large cohort of US cancer survivors.
  • To identify demographic and temporal factors associated with fatal infections in cancer patients.

Main Methods:

  • Utilized data from 7,529,481 US cancer survivors (1992-2015) from the Surveillance, Epidemiology, and End Results (SEER) database.
  • Calculated standardized mortality ratios (SMRs) and performed Fine-Gray survival analysis to adjust for competing risks.

Main Results:

  • 1.3% of cancer survivors (101,167) died from infection, with an SMR of 3.29 compared to the general population.
  • Higher risk observed in older, male, Black, and unmarried patients.
  • Risk of infection mortality is highest within the first year post-diagnosis (SMR: 8.68) and decreases over time, though it remains elevated (>10 years: SMR: 2.93).
  • Certain cancers like Hodgkin Lymphoma, Non-Hodgkin Lymphoma, and Kaposi Sarcoma have a high proportion of early deaths due to infection, while liver cancer shows an increasing relative infection mortality risk over time.

Conclusions:

  • This study provides a detailed characterization of infection mortality patterns in patients living with cancer.
  • Findings can inform the development of targeted research and interventions to reduce infection-related deaths in this vulnerable population.