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Non-Cancer-Related Causes' Impact on Lung Cancer Survival: SEER Analysis
Lin-Miao Zeng1, Jie-Huang Zhang2, Li-Ping Lin3
1Department of Respiratory and Critical Care Medicine, Mindong Hospital Affiliated to Fujian Medical University, Fu'an, Fujian, 355000 China.
Indian Journal of Surgical Oncology
|August 6, 2026
Summary
Non-cancer deaths are rising in lung cancer survivors, surpassing cancer deaths after five years. Cardiovascular and respiratory diseases are key concerns, with older age and lack of treatment increasing risks.
Area of Science:
- Oncology
- Epidemiology
- Public Health
Background:
- Lung cancer (LC) patient survival is improving, leading to increased focus on non-cancer mortality.
- Temporal trends and risk factors for non-cancer deaths in LC survivors require systematic evaluation.
Purpose of the Study:
- To systematically evaluate standardized mortality ratios (SMRs) for non-cancer deaths in lung cancer patients.
- To analyze the temporal dynamics and identify risk factors for non-cancer mortality in this population.
Main Methods:
- Analysis of 371,177 lung cancer patients from the SEER database (2000-2019).
- Categorization of non-cancer deaths into infectious, diabetes, cardiovascular, respiratory, digestive, and other causes.
- Calculation of SMRs and application of Fine-Gray models to assess mortality risks.
Main Results:
- Non-cancer deaths significantly increased over time, exceeding cancer-specific mortality after five years post-diagnosis (overall SMR = 2.24).
- Cardiovascular (SMR = 4.85) and respiratory diseases (SMR = 3.56) were the predominant non-cancer causes.
- Peak non-cancer mortality occurred between 1-5 years post-diagnosis (SMR = 2.33), with advanced age, male sex, advanced stage, and lack of treatment identified as risk factors.
Conclusions:
- A significant shift in mortality is observed in lung cancer survivors, driven by aging and treatment complications.
- Multidisciplinary survivorship programs are essential, prioritizing cardiovascular monitoring and lifestyle interventions.
- Structured follow-up for untreated patients and interventions like smoking cessation can reduce preventable deaths and improve survivor outcomes.
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