Competing Risks of Cancer and Non-Cancer Mortality When Accompanied by Lifestyle-Related Factors—A Prospective Cohort Study in Middle-Aged and Older Adults

Abstract

BackgroundThe study aimed to identify the association between the lifestyle-related factors and the cancer-specific, or non-cancer-specific mortality, when accompanied by a competing risk. Two statistical methods were applied, i.e., cause-specific hazard (CSH), and sub-distribution hazard ratio (SHR). Their respective key advantages, relative to the actual study design, were addressed, as was overall application potential.MethodsSource data from 4,584 residents (34.2% men), aged 45–64 years, were processed using two different families of regression models, i.e., CSH and SHR; principal focus upon the impact of lifestyle-related factors on the competing risk of cancer and non-cancer mortality. The results were presented as hazard ratios (HR) with 95% confidence intervals (95% CI).ResultsAge, smoking status, and family history of cancer were found the leading risk factors for cancer death; the risk of non-cancer death higher in the elderly, and smoking individuals. Non-cancer mortality was strongly associated with obesity and hypertension. Moderate to vigorous physical activity decreased the risk of death caused by cancer and non-cancer causes.ConclusionsSpecific, lifestyle-related factors, instrumental in increasing overall, and cancer-specific mortality, are modifiable through health-promoting, individually pursued physical activities. Regular monitoring of such health-awareness boosting pursuits seems viable in terms of public health policy making.

Agreement between Accelerometer-Assessed and Self-Reported Physical Activity and Sedentary Behavior in Female Breast Cancer Survivors

“…The measurements of waist and hip circumferences were taken using a metric, nonelastic measuring tape, positioned parallel to the floor and recorded to an accuracy of 0.1 cm, in line with anthropometric measurement guidelines [24][25][26]. In accordance with the WHO protocols, WC was measured at the midpoint between the iliac crest and the lower border of the last palpable rib, in the mid-axillary line.…”

Impact of Residential Concentration of PM2.5 Analyzed as Time-Varying Covariate on the Survival Rate of Lung Cancer Patients: A 15-Year Hospital-Based Study in Upper Northern Thailand

“…Deaths of lung cancer patients are caused by various risk factors, the main one being smoking [7][8][9][10][11][12]. A large Norwegian study found that men who smoke had a 27-fold higher risk of death [12].…”

“…A large Norwegian study found that men who smoke had a 27-fold higher risk of death [12]. Other characteristics related to the mortality of lung cancer are sex (men have a higher risk than women) [7,12], age (a higher risk with increasing age) [7,10,11], body mass index (being overweight is riskier) [13,14], family history [8,10], and cancer stage [7,15]. Furthermore, external factors such as air pollution can have a significant effect on mortality; for example, PM (both PM ≤ 2.5 µm (PM2.5) [16][17][18][19][20][21][22][23] and PM ≤ 10 µm (PM10) [19,[22][23][24][25][26][27]), NO 2 [22,23] and O 3 [28].…”

Development and Modeling of Decision Tree for Survival Data with Multiple Events Using Deviance and Cox-Snell Residuals within Node Homogeneity Technique

“…Here only one event is of interest to the researcher, however, when considering another effect such as death due to other risks factors in the isolation center, then this is referred to as survival data with multiple events or simply competing risks [2]. In another word, when other events prevent the occurrence of events of interest, then, we say competing events (risk) exist [3]. Researchers such [4], [5], [6], and so on have applied the classical concept of analyzing survival data in the realm of nonparametric and semiparametric methods.…”