Prediction of cancer survivors' mortality risk in Korea: a 25-year nationwide prospective cohort study

양연수; Kimm Hee Jin; 정금지; Moon Seul Ji; Lee Sun Mi; 지선하

doi:10.4178/epih.e2022075

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저자정보: 양연수 (연세대학교 국민건강증진연구소) Kimm Hee Jin (2 Department of Epidemiology and Health Promotion Institute for Health Promotion Graduate School o) 정금지 (연세대학교) Moon Seul Ji (Department of Epidemiology and Health Promotion, Institute for Health Promotion, Graduate School of Public Health, Yonsei University) Lee Sun Mi (Health Insurance Policy Research Institute National Health Insurance Service) 지선하 (연세대학교)

저널정보: 한국역학회 Epidemiology and Health Epidemiology and Health Vol.44

발행연도: 2022.1

수록면: 1 - 10 (10page)

DOI: 10.4178/epih.e2022075

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OBJECTIVES: This study aimed to investigate the factors affecting cancer survival and develop a mortality prediction model for Korean cancer survivors. Our study identified lifestyle and mortality risk factors and attempted to determine whether health-promoting lifestyles affect mortality. METHODS: Among the 1,637,287 participants in the Korean Cancer Prevention Study (KCPS) cohort, 200,834 cancer survi vors who were alive after cancer diagnosis were analyzed. Discrimination and calibration for predicting the 10-year mortality risk were evaluated. A prediction model was derived using the Cox model coefficients, mean risk factor values, and mean mor tality from the cancer survivors in the KCPS cohort. RESULTS: During the 21.6-year follow-up, the all-cause mortality rates of cancer survivors were 57.2% and 39.4% in men and women, respectively. Male sex, older age, current smoking, and a history of diabetes were high-risk factors for mortality, while exercise habits and a family history of cancer were associated with reduced risk. The prediction model discrimination in the validation dataset for both KCPS all-cause mortality and KCPS cancer mortality was shown by C-statistics of 0.69 and 0.68, re spectively. Based on the constructed prediction models, when we modified exercise status and smoking status, as modifiable factors, the cancer survivors’ risk of mortality decreased linearly. CONCLUSIONS: A mortality prediction model for cancer survivors was developed that may be helpful in supporting a healthy life. Lifestyle modifications in cancer survivors may affect their risk of mortality in the future.

#: Cancer survivor #Prediction #Mortality risk factors #Lifestyle modification #Tobacco smoking

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