medwireNews: Analysis of US data has shown an increase in age-adjusted mortality rates (AAMRs) due to acute pulmonary embolism (PE) in patients with cancer over the past decade.
This rise was observed “despite decreases in cancer-related mortality rates,” highlight Gregory Piazza (Brigham and Women’s Hospital, Boston, Massachusetts, USA) and associates in JAMA Network Open.
They write: “These findings highlight a concerning increase in PE-related mortality in patients with cancer, indicating a need for further research and preventive interventions to improve outcomes.”
Using the US Centers for Disease Control and Prevention Wide-Ranging Online Data for Epidemiologic Research dataset, the team sought to identify “changes in national trends in [PE]-related mortality rates in patients with cancer between 2011 and 2020.”
During this time period, there were a total of 27,280,194 deaths among individuals aged 15 years or older.
Among patients with cancer, PE-related mortality rates rose by 44.3% from 1360 deaths per 100,000 cases in 2011 to 1963 deaths per 100,000 cases in 2020.
The AAMR for deaths due to PE in people with cancer increased from 3.18 deaths per 100,000 cases in 2011 to 4.05 deaths per 100,000 cases in 2020, equating to an average annual percent change (AAPC) of 2.5% over the study period, with a similar AAPC among men and women, at 2.3% and 2.7%, respectively.
Of concern, there appeared to be a greater increase in AAMRs for PE-related deaths among patients aged 15–64 years than those aged 65 years or more, with respective AAPCs of 3.2% and 2.7%.
There was also an increase in AAMRs for deaths due to PE among White, Black or African American, and Hispanic and Latinx people, with AAPCs of 2.7%, 2.2%, and 2.6%, respectively. But “mortality rates plateaued” for Asian or Pacific Islander and American Indian or Alaska Native individuals, report the researchers.
They add that “the PE-related mortality trend exhibited a 2-phase pattern across all patient subgroups characterized by an initial plateau from 2011 to 2015, followed by a subsequent period of rapid growth from 2015 to 2020.”
Piazza and colleagues continue: “Recognition and confirmation of such patterns may inform further research into thromboprophylaxis and treatment of PE as a complication of cancer and cancer-directed therapy.”
Analyzing data from US Cancer Statistics (USCS), the investigators found that although the absolute numbers of new cancer cases and cancer-related deaths rose during the study period, the age-adjusted incidences decreased, with corresponding AAPCs of –1.0% and –1.8%.
“This finding suggests that indeed more patients with advanced and high-risk cancers may live longer, making them more prone to developing and dying from PE,” write the study authors.
“Furthermore, the improved survival rates in individuals with cancer may favor exposure to additional contributing risks that could heighten susceptibility to PE, including acute and chronic complications of oncological therapy and accrual of chronic medical illnesses which may potentially increase susceptibility to PE and impact PE-related mortality.”
They caution though that this analysis of USCS data “was not intended for direct comparison with AAMR but rather to elucidate trends in PE-related mortality among patients with cancer, considering that the prevalence of cancer may have influenced related mortality trends.”
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