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. 2025 Jan 14;26(1):25277.
doi: 10.31083/RCM25277. eCollection 2025 Jan.

Cardiovascular Disease and Other Competing Causes of Death in Older Kidney Cancer Patients

Yinglan Liang  1   2 , Liangjia Zeng  2   3 , Ruoyun Zhou  2   4 , Manting Feng  2   5 , Linglong Liu  1   2 , Kexin Chen  2   3 , Jinqi Huang  2   6 , Haowen Liang  2   4 , Baixin He  2   5 , Binghua Zhang  2   7 , Yican Ying  2   5 , Yuerong Chen  8 , Tianwang Guan  9 , Min Yi  10
Affiliations

Cardiovascular Disease and Other Competing Causes of Death in Older Kidney Cancer Patients

Yinglan Liang et al. Rev Cardiovasc Med. .

Abstract

Background: To study the risk of cardiovascular disease (CVD) and other competing causes of death in older kidney cancer patients.

Methods: Data on older patients (aged 65 and above) diagnosed with kidney cancer between 1975 and 2018 were extracted from the Surveillance, Epidemiology, and End Results (SEER) database. We delved into the distribution of CVD and other competing causes of death across the entire cohort and in various patient subgroups. The competing risk analysis was used to produce cumulative mortality curves based on cumulative mortality for the primary outcomes by follow-up period. Utilizing the standardized mortality ratios (SMRs) and absolute excess risks (AERs), we contrasted the risk of CVD and other competing causes of death in older kidney cancer patients to that observed in the general population.

Results: The analysis included 29,349 older kidney cancer patients, of which included 4563 CVD deaths. As survival time extended, the proportion of non-cancer deaths increased in older kidney cancer patients, with CVD accounting for the largest share of non-cancer deaths. At 10-15 years after diagnosis, cumulative non-cancer mortality exceeded primary kidney cancer as the predominant cause of death, and cumulative CVD mortality is higher among all non-cancer causes. Older kidney cancer patients exhibited a greater risk of CVD and other non-cancer deaths than their counterparts in the general older population did (SMR: 1.38-2.81; AER: 1.1-143.69).

Conclusions: As survival time increases, the risk of non-cancer death in older kidney cancer patients gradually surpassed that of primary cancer, and CVD death accounted for the majority of non-cancer deaths. Among older kidney cancer patients, the risk of CVD mortality was higher than in the general population. Managing non-cancer deaths, especially CVD deaths, should be a focus in the care of older kidney cancer patients.

Keywords: cardio-oncology; cardiovascular disease death; cause of death; kidney cancer; older patients.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Fig. 1.
Fig. 1.
The distribution of all causes of death in older kidney cancer patients. y, year; CVD, cardiovascular disease.
Fig. 2.
Fig. 2.
The distribution of non-cancer death in older kidney cancer patients. y, year; CVD, cardiovascular disease.
Fig. 3.
Fig. 3.
Cumulative mortality in older kidney cancer patients. (A) All causes of death. (B) Non-cancer death. CVD, cardiovascular disease.
Fig. 4.
Fig. 4.
Standardized mortality ratios for each non-cancer cause of death in older kidney cancer patients. SMR, standardized mortality ratio; CVD, cardiovascular disease; COPD, chronic obstructive pulmonary disease; CLD, chronic liver disease.
See this image and copyright information in PMC

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