This cohort study uses Surveillance, Epidemiology, and End Results (SEER) data to evaluate the incidence of death from unintentional injury among patients with cancer compared with the general population in the United States.
Key Points Question Is the incidence of death from unintentional injury among patients with cancer higher than that in the general population? Findings In this cohort study using Surveillance, Epidemiology, and End Results program data from 8 271 020 patients, the incidence of death from unintentional injury among patients with cancer in the United States was 60% higher than that in the general US population. The highest rates of death from unintentional injury were observed among patients with liver cancer and were within the first month after diagnosis. Meaning The findings suggest that, for clinicians at all levels of health care, death from unintentional injury among patients with cancer requires more attention.
Importance Previous studies have suggested that patients with cancer may be at an increased risk of death from unintentional injury, but to our knowledge, no large studies have examined the rates of death from unintentional injury among patients with cancer. Objective To characterize the incidence of death from unintentional injury among patients with cancer in the United States. Design, Setting, and Participants This retrospective cohort study included patients diagnosed with a first primary cancer between January 1, 1973, and December 31, 2015, identified from the Surveillance, Epidemiology, and End Results (SEER) program data. Comparisons with the general US population were based on mortality data collected by the National Center for Health Statistics. Analyses were performed from February 1, 2019, to August 15, 2019. Main Outcomes and Measures Rates and standardized mortality ratios (SMRs) of death from unintentional injury among patients with cancer. Results A total of 8 271 020 patients with cancer were included in this study (50.2% female; mean [SD] age, 63.0 [15.7] years). Among them, 40 599 deaths from unintentional injury were identified. The rates of death from unintentional injury were 81.90 per 100 000 person-years among patients with cancer and 51.21 per 100 000 person-years in the corresponding US general population. The SMR of death from unintentional injury was 1.60 (95% CI, 1.58-1.61). Higher rates of death from unintentional injury were associated with increasing age at diagnosis (≥80 years; rate ratio [RR], 2.91; 95% CI, 2.84-2.98; P