Causes of Death among Cancer Patients: Emerging Trends in the 21st Century

Most studies examining the causes of cancer-related deaths have primarily focused on specific cancer types, often neglecting the evolving spectrum of death causes among cancer patients in the 21st century. This study, utilizing data from the National Cancer Institutes Surveillance, Epidemiology, and End Results (SEER) Program, analyzed the causes of death in patients diagnosed with 36 types of cancer between 2000 and 2021. By categorizing these causes into deaths from index cancers, non-index cancers, and non-cancer causes, this study provides a comprehensive analysis of cause-of-death patterns and emerging trends, stratified by year of death, age at diagnosis, and survival duration. The findings reveal that while relative mortality rates from index cancers remain elevated for brain, pancreatic, and gallbladder cancers, significant declines were observed for lung, liver, nasopharyngeal, and esophageal cancers, as well as multiple myeloma cancers, reflecting advancements in cancer treatment. Besides, relative mortality rates from non-index cancers surpassed those from index cancers in oral cavity, oropharyngeal, vaginal, and small intestine cancers, indicating a potential benefit from enhanced surveillance and early detection of non-index cancers in these patient populations. Importantly, non-cancer-related causes of death, such as heart disease, chronic liver disease and cirrhosis, also emerged as prominent contributors to mortality among cancer patients. The results of this study offer critical and current data to inform public health policy, optimize healthcare resource allocation, and facilitate international collaboration in cancer research and control. Meanwhile, this study is of great reference value for developing countries to formulate medium- and long-term public health policies.