Non-cancer-related Deaths in Cancer Survivors: A Nationwide Population-based Study in Japan

Gon, Yasufumi; Zha, Ling; Morishima, Toshitaka; Kimura, Yasuyoshi; Asai, Kanako; Kudo, Haruka; Sasaki, Tsutomu; Mochizuki, Hideki; Miyashiro, Isao; Sobue, Tomotaka

doi:https://doi.org/10.2188/jea.JE20240230

Non-cancer-related Deaths in Cancer Survivors: A Nationwide Population-based Study in Japan

Gon, Yasufumi; Zha, Ling; Morishima, Toshitaka et al.

Journal of Epidemiology, 2025, 35(3), 147-153

Number of Access:1,229（2025-08-14 05:39 Counts）

Identifier to cite or link to this item: https://hdl.handle.net/11094/100601

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Title	Non-cancer-related Deaths in Cancer Survivors: A Nationwide Population-based Study in Japan
Creator	NRID 1000070751311 1000070751311 researchmap permalink y-gon y-gon Scopus Author ID 56565092900 56565092900 CreatorName Gon, Yasufumi
	researchmap permalink lingzha lingzha Scopus Author ID 57193822882 57193822882 CreatorName Zha, Ling
	NRID 1000010728893 1000010728893 CreatorName Morishima, Toshitaka
	NRID 1000050727451 1000050727451 ORCID 0000-0001-9147-8058 0000-0001-9147-8058 researchmap permalink y-kimura_neurol y-kimura_neurol Scopus Author ID 56673363900 56673363900 CreatorName Kimura, Yasuyoshi
	CreatorName Asai, Kanako
	CreatorName Kudo, Haruka
	NRID 1000020534879 1000020534879 ORCID 0000-0001-8726-978X 0000-0001-8726-978X researchmap permalink tsutomusasaki1111 tsutomusasaki1111 Scopus Author ID 7407394272 7407394272 CreatorName Sasaki, Tsutomu
	NRID 1000090230044 1000090230044 ORCID 0000-0002-0874-7542 0000-0002-0874-7542 researchmap permalink read0207787 read0207787 Scopus Author ID 7202006099 7202006099 CreatorName Mochizuki, Hideki
	NRID 1000080501824 1000080501824 CreatorName Miyashiro, Isao
	NRID 1000050270674 1000050270674 researchmap permalink read_0159567 read_0159567 Scopus Author ID 7005649935 7005649935 CreatorName Sobue, Tomotaka
Subject	cancer
	survivor
	non-cancer-related mortality
	cohort study
Description	Gon Yasufumi, Zha Ling, Morishima Toshitaka, et al. Non-cancer-related Deaths in Cancer Survivors: A Nationwide Population-based Study in Japan. Journal of Epidemiology 35, 147 (2025); https://doi.org/10.2188/jea.JE20240230.
Abstract	Background: Advancements in cancer care have improved survivorship, potentially leading to changes in mortality causes. This study aimed to investigate the causes of death among cancer survivors, specially focusing on non-cancer-related mortality. Methods: This nationwide population-based cohort study analyzed the causes of death based on the time since cancer diagnosis using data from the National Cancer Registry in Japan between January 2016 and December 2019. Non-cancer-related deaths were identified, and mortality risks associated with non-cancer diseases were compared to those of the Japanese general population using standardized mortality ratios (SMRs) with 95% confidence intervals (CIs). The follow-up period was up to 4 years after cancer diagnosis. Results: A total of 3,990,661 patients (45.8% women) were included in the analysis, yielding 6,237,269 person-years of follow-up. Of these, 1,001,857 (25.1%) patients died during the study period. Cancer-related and non-cancer-related causes accounted for 86.6% and 13.4% of deaths, respectively. The proportion of non-cancer-related deaths increased from 10.2% at 6 months to 31.6% at 4 years after cancer diagnosis. Heart disease (21.8%), cerebrovascular disease (9.8%), and pneumonia (9.1%) were the leading cause of non-cancer-related deaths: the SMRs for these diseases were 2.69 (95% CI, 2.66–2.72), 2.07 (95% CI, 2.03–2.10), and 2.41 (95% CI, 2.36–2.45), respectively. The SMR for suicide was 1.81 (95% CI, 1.74–1.89); however, it lost significance in males and females 2 and 2.5 years after cancer diagnosis, respectively. Conclusion: The proportion of non-cancer-related deaths among cancer patients has increased over time, emphasizing the need to manage cancer and its comorbidities carefully.
Publisher	Japan Epidemiological Association
Source Title	Journal of Epidemiology
Volume (Issue)	35(3)
Page	147-153
Date of Issued	2025-03-05
Language	English
Handle URL	https://hdl.handle.net/11094/100601
PISSN	09175040
eISSN	13499092
Relation.isIdenticalTo	DOI (Publisher Version) https://doi.org/10.2188/jea.JE20240230
Access Rights	open access
CopyRight	This article is licensed under a Creative Commons Attribution 4.0 International License.
oaire:version	Version of Record
Category	学術雑誌論文 Journal Article

Resource Type	journal article
Local Type	Journal Article
DCTERMS.bibliographicCitation	Journal of Epidemiology. 2025, 35(3), p. 147-153
DC.title	Non-cancer-related Deaths in Cancer Survivors: A Nationwide Population-based Study in Japan
DC.creator	Gon, Yasufumi
	Zha, Ling
	Morishima, Toshitaka
	Kimura, Yasuyoshi
	Asai, Kanako
	Kudo, Haruka
	Sasaki, Tsutomu
	Mochizuki, Hideki
	Miyashiro, Isao
	Sobue, Tomotaka
DC.publisher	Japan Epidemiological Association
DC.language' scheme='DCTERMS.RFC1766	English
DCTERMS.issued' scheme='DCTERMS.W3CDTF	2025-03-05
DC.identifier	https://doi.org/10.2188/jea.JE20240230
DC.subject	cancer
	survivor
	non-cancer-related mortality
	cohort study
DC.description	Gon Yasufumi, Zha Ling, Morishima Toshitaka, et al. Non-cancer-related Deaths in Cancer Survivors: A Nationwide Population-based Study in Japan. Journal of Epidemiology 35, 147 (2025); https://doi.org/10.2188/jea.JE20240230.
DCTERMS.abstract	Background: Advancements in cancer care have improved survivorship, potentially leading to changes in mortality causes. This study aimed to investigate the causes of death among cancer survivors, specially focusing on non-cancer-related mortality. Methods: This nationwide population-based cohort study analyzed the causes of death based on the time since cancer diagnosis using data from the National Cancer Registry in Japan between January 2016 and December 2019. Non-cancer-related deaths were identified, and mortality risks associated with non-cancer diseases were compared to those of the Japanese general population using standardized mortality ratios (SMRs) with 95% confidence intervals (CIs). The follow-up period was up to 4 years after cancer diagnosis. Results: A total of 3,990,661 patients (45.8% women) were included in the analysis, yielding 6,237,269 person-years of follow-up. Of these, 1,001,857 (25.1%) patients died during the study period. Cancer-related and non-cancer-related causes accounted for 86.6% and 13.4% of deaths, respectively. The proportion of non-cancer-related deaths increased from 10.2% at 6 months to 31.6% at 4 years after cancer diagnosis. Heart disease (21.8%), cerebrovascular disease (9.8%), and pneumonia (9.1%) were the leading cause of non-cancer-related deaths: the SMRs for these diseases were 2.69 (95% CI, 2.66–2.72), 2.07 (95% CI, 2.03–2.10), and 2.41 (95% CI, 2.36–2.45), respectively. The SMR for suicide was 1.81 (95% CI, 1.74–1.89); however, it lost significance in males and females 2 and 2.5 years after cancer diagnosis, respectively. Conclusion: The proportion of non-cancer-related deaths among cancer patients has increased over time, emphasizing the need to manage cancer and its comorbidities carefully.
DC.rights	This article is licensed under a Creative Commons Attribution 4.0 International License.
DC.format	100601
citation_title	Non-cancer-related Deaths in Cancer Survivors: A Nationwide Population-based Study in Japan
citation_author	Gon, Yasufumi
	Zha, Ling
	Morishima, Toshitaka
	Kimura, Yasuyoshi
	Asai, Kanako
	Kudo, Haruka
	Sasaki, Tsutomu
	Mochizuki, Hideki
	Miyashiro, Isao
	Sobue, Tomotaka
citation_publisher	Japan Epidemiological Association
citation_language	English
citation_date	2025-03-05
citation_journal_title	Journal of Epidemiology
citation_volume	35
citation_issue	3
citation_firstpage	147
citation_lastpage	153
citation_doi	https://doi.org/10.2188/jea.JE20240230
citation_public_url	https://hdl.handle.net/11094/100601

Non-cancer-related Deaths in Cancer Survivors: A Nationwide Population-based Study in Japan

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