Cancer Epidemiology最新文献

{"title":"Incidence trends and survival of cervical cancer: A population-based study on Thai Cancer registry database","authors":"Apirak Nguanboonmak ,&nbsp;Boonyita Pakkaranang ,&nbsp;Marut Yanaranop ,&nbsp;Pichaya Tantiyavarong","doi":"10.1016/j.canep.2026.102992","DOIUrl":"10.1016/j.canep.2026.102992","url":null,"abstract":"<div><h3>Background</h3><div>Cervical cancer remains common among Thai women, but nationwide evidence on incidence and survival is limited. This study analyzed trends over the past decade.</div></div><div><h3>Methods</h3><div>We conducted a nationwide, retrospective cohort study using data from the Thai national population-based cancer registry. The study included women diagnosed with cervical cancer between 2012 and 2022. Age-standardized incidence rates (ASR) were calculated using the WHO standard population. Relative survival was estimated using the Ederer II method, based on national life tables.</div></div><div><h3>Results</h3><div>A total of 47,220 newly diagnosed cervical cancer cases were included. The ASR ranged from 7.69 to 11.18 per 100,000 women. Incidence increased from 2012 to 2015 (slope = +0.43), then declined until 2021 (slope = –0.36), with a slight resurgence in 2022. Younger women (aged 30–39 years) exhibited a steadily increasing incidence trend. The overall 5-year relative survival rate was 75 % (95 % CI, 74–75 %), and survival rates at 1, 3, and 5 years declined progressively throughout the study period.</div></div><div><h3>Conclusion</h3><div>While cervical cancer incidence in Thailand declined overall from 2012 to 2022, rates increased among younger women. Relative survival also declined over time. These findings underscore the need to re-evaluate national screening strategies, particularly for younger populations, and to strengthen timely access to diagnosis and treatment.</div></div>","PeriodicalId":56322,"journal":{"name":"Cancer Epidemiology","volume":"101 ","pages":"Article 102992"},"PeriodicalIF":2.3,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146024977","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The International Classification of Diseases for Oncology, 4th Edition (ICD-O-4): An overview","authors":"Ariana Znaor ,&nbsp;Brian Rous ,&nbsp;Gabrielle Goldman Levy ,&nbsp;Reiko Watanabe ,&nbsp;Robert Jakob ,&nbsp;Eva Krpelanova ,&nbsp;Harshima D. Wijesinghe ,&nbsp;Pavitratha Puspanathan ,&nbsp;Ian A. Cree ,&nbsp;Freddie Bray ,&nbsp;Dilani Lokuhetty","doi":"10.1016/j.canep.2026.102989","DOIUrl":"10.1016/j.canep.2026.102989","url":null,"abstract":"<div><h3>Background</h3><div>The International Classification of Diseases for Oncology (ICD-O) was specifically developed for coding tumours according to their site of origin (topography), microscopic appearance or histology, behaviour and grade (morphology), and is optimal for use in cancer registries. The fourth edition of the ICD-O (ICD-O-4) aims to provide an improved structure of unique codes to existent and newly defined tumour entities and has been harmonised with the International Classification of Diseases 11th Edition (ICD-11).</div></div><div><h3>Methods</h3><div>Based on an International Association of Cancer Registries (IACR) survey of cancer registries, over 90 % of the respondents (250 of 276) agreed to an update of ICD-O-3.2 morphology by the addition of a fifth digit to the existing four-digit histology code. Following the 5th Edition of the WHO Classification of Tumours (WCT), a beta version of ICD-O-4 was developed and disseminated for open consultation by the International Agency on Research for Cancer (IARC) on the WCT website.</div></div><div><h3>Results</h3><div>Following closure of the consultation period, the ICD-O-4 codes were finalized. The main changes in comparison to ICD-O-3.2 include the addition of a 5th alphanumeric digit to the histology code, changes in the first four digits of histology codes, changes of behaviour codes (e.g. pituitary adenoma code changed from /1 to /3), a new topography code for gastroesophageal junction (C16.7), detailed codes for extrahepatic bile ducts (C24.2, C24.3) and cystic duct (C24.4), change of the code for anal skin cancer from skin to anus (C44.5 to C21.3) and an optional additional digit in the topography code.</div></div><div><h3>Conclusion</h3><div>ICD-O-4 is compiled in consultation with pathologists, epidemiologists, public health researchers as well as the cancer registry community. The five-digit histology codes enable a hierarchical and detailed coding of tumours, while the new topography and behaviour codes reflect the evidence base on tumour aetiology, stage and behaviour.</div></div>","PeriodicalId":56322,"journal":{"name":"Cancer Epidemiology","volume":"101 ","pages":"Article 102989"},"PeriodicalIF":2.3,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146024998","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Temporal trends in breast cancer incidence and mortality in Australia: An Age-Period-Cohort analysis","authors":"Phuong Dung Nguyen ,&nbsp;Andrew N. Page ,&nbsp;Kate A. McBride ,&nbsp;Matthew J. Spittal ,&nbsp;Sithum Munasinghe","doi":"10.1016/j.canep.2026.103017","DOIUrl":"10.1016/j.canep.2026.103017","url":null,"abstract":"<div><h3>Background</h3><div>Breast cancer is the most diagnosed cancer among Australian women. Recently, incidence rates have risen but mortality rates have decreased. The extent to which these changes are the result of cumulative risk factor effects (age-effects), events affecting all women at specific points in time (period effects), or changes in generational risk factors (cohort effects) is unclear. This study investigates whether observed trends in breast cancer incidence and mortality are associated with age, period, or cohort effects.</div></div><div><h3>Methods</h3><div>Annual Australian breast cancer incidence (1982–2020) and mortality data (1907–2022) were obtained from the Australian Institute of Health and Welfare. Age-Period-Cohort (APC) modelling with a drift in cohort function was used to estimate adjusted age, period and cohort effects.</div></div><div><h3>Results</h3><div>Age effects showed higher incidence and mortality rates with increasing age, peaking at 75–84 years. Cohort effects showed progressively increasing risk among women born after the 1940s, with higher incidence among younger cohorts. Incidence peaks corresponded with introduction of population-based mammography screening, and also changes in population level risk factors. Period effects (adjusting for cohort effects) were modest, demonstrating reductions in incidence over time, while mortality peaked in the 1990s before declining after 2000.</div></div><div><h3>Conclusion</h3><div>Increasing age-related breast cancer incidence and mortality reinforce the importance of early prevention. Incidence has shifted due to cohort and period effects with younger generations showing the highest increases in incidence, suggesting generational shifts in breast cancer risk, likely attributable to mammography screening and increased prevalence of modifiable risk factors.</div></div>","PeriodicalId":56322,"journal":{"name":"Cancer Epidemiology","volume":"101 ","pages":"Article 103017"},"PeriodicalIF":2.3,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146173874","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Temporal trends in prostate cancer incidence, mortality, and survival in the health regions of Sergipe, Brazil, 1996-2022","authors":"Ana Clara Cruz Santos de Santana ,&nbsp;Brenda Evelin Barreto da Silva ,&nbsp;Ellen Sabrina Ramos Santos ,&nbsp;Jefferson Felipe Calazans Batista ,&nbsp;Alex Rodrigues Moura ,&nbsp;Carlos Anselmo Lima","doi":"10.1016/j.canep.2026.103026","DOIUrl":"10.1016/j.canep.2026.103026","url":null,"abstract":"<div><h3>Objective</h3><div>to examine the temporal trends of these indicators across the state’s health regions to provide evidence that supports improvements in public policies and actions aimed at disease control.</div></div><div><h3>Material and methods</h3><div>Ecological study conducted in Sergipe state, Brazil. We used anonymized data on malignant prostate neoplasms (ICD-10 C61) from the Aracaju Cancer Registry (ACR) for 1996–2017. Mortality data were obtained from the Mortality Information System (SIM) for 1996–2022. Age-specific and age-standardized incidence and mortality rates were calculated. The Mortality-to-Incidence Ratio (MIR) and its complement (1–MIR) were used as indirect indicators of five-year survival. Temporal trends were assessed using Joinpoint regression (version 5.3.0), estimating APC, AAPC and 95 % confidence intervals using Monte Carlo permutation tests.</div></div><div><h3>Results</h3><div>A total of 10,133 prostate cancer cases were recorded from 1996 to 2017. The age-standardized incidence rate increased from 42.4 per 100,000 (1996–2005) to 76.8 per 100,000 (2006–2012), decreasing slightly to 72.3 per 100,000 (2013–2017). The overall annual increase was 6.63 %, with Aracaju showing 6.85 %. Declines occurred only in Nossa Senhora do Socorro from 2007 to 2017 (APC: –1.85; 95 %CI: –3.59; –0.26). Between 1980–2022, age-standardized mortality increased 4.20 % annually (95 %CI: 3.35–4.81), with marked rises in Estância (7.20 %), Propriá (6.02 %), Lagarto (5.53 %), Nossa Senhora da Glória (4.83 %), and Itabaiana (2.89 %). MIR-based survival declined from 76.57 % (1996–1999) to 71.27 % (2015–2017), with increased MIR among adults aged 75 + , decreasing MIR among individuals aged 15–54—especially in the capital—and increases across all age groups in Propriá.</div></div><div><h3>Conclusion</h3><div>Prostate cancer in Sergipe demonstrates significant regional and age-related disparities in incidence, mortality, and survival. Rising incidence and mortality, along with adverse MIR trends, underscore the need for targeted health policies to improve early detection, treatment access and long-term outcomes.</div></div>","PeriodicalId":56322,"journal":{"name":"Cancer Epidemiology","volume":"101 ","pages":"Article 103026"},"PeriodicalIF":2.3,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146260247","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comment on “Association between blood cholesterol profile and risk of lung cancer: A meta-analysis of prospective cohort studies”","authors":"Sushma Narsing Katkuri,&nbsp;Zarine Khan,&nbsp;Rhushvi Thakkar,&nbsp;Archana Dhyani,&nbsp;Hariharan Srinivasan","doi":"10.1016/j.canep.2026.103000","DOIUrl":"10.1016/j.canep.2026.103000","url":null,"abstract":"","PeriodicalId":56322,"journal":{"name":"Cancer Epidemiology","volume":"101 ","pages":"Article 103000"},"PeriodicalIF":2.3,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146020735","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Survival of all cancer sites combined: Partitioning of temporal changes into cancer, non-cancer and case-mix","authors":"Paul C. Lambert ,&nbsp;Yngvar Nilssen ,&nbsp;Tor Åge Myklebust ,&nbsp;Bjarte Aagnes ,&nbsp;Bjørn Møller ,&nbsp;Mark J. Rutherford","doi":"10.1016/j.canep.2026.102999","DOIUrl":"10.1016/j.canep.2026.102999","url":null,"abstract":"<div><div>Quantifying cancer survival is a crucial component of cancer surveillance and control. Survival for all cancers combined is an overall summary to explore differences between population groups and over time. Net survival is the usual measure for reporting survival for all cancers combined. Differences in the cancer site distribution between groups can be adjusted for using standardization. We propose using individual weights incorporated into the Pohar Perme estimator of net survival for standardized all cancers combined survival estimates, rather than a weighted average of stratum specific estimates. This removes sparse data problems, where estimates are unobtainable for some strata. Extending to reference adjusted all-cause survival gives an alternative, interpretable measure, enabling partitioning of all-cause survival differences into those due to cancer site/age/sex distribution differences, other cause mortality differences and cancer mortality differences. We illustrate the methods using data on 749 889 individuals diagnosed with cancer in Norway 1986–2021. Using individual weights gives very similar estimates to traditional and model-based standardization and avoids using ad-hoc sparse data methods. Reference adjusted all-cause survival provides measures with simpler interpretation. For example, between 1986 and 1990 and 2016–2021 there was a 25.9 %age point improvement in 5-year all-cause survival. This improvement was partitioned into changes in the site/age/sex distribution (2.0), changes in other cause mortality rates (4.4) with the majority (19.6) due to improvements in cancer survival. Survival of all cancers combined is easily analyzed non-parametrically using individual weights. Reference adjusted all-cause survival gives a more interpretable measure improving understanding of differences over time/between groups.</div></div>","PeriodicalId":56322,"journal":{"name":"Cancer Epidemiology","volume":"101 ","pages":"Article 102999"},"PeriodicalIF":2.3,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146024975","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cardiovascular disease mortality among women diagnosed with de novo metastatic breast cancer","authors":"Cody Ramin ,&nbsp;Gillian Gresham ,&nbsp;Jessica Li ,&nbsp;Anja Karlstaedt ,&nbsp;Mia Hashibe ,&nbsp;Andriana P. Nikolova ,&nbsp;Katelyn M. Atkins","doi":"10.1016/j.canep.2026.103025","DOIUrl":"10.1016/j.canep.2026.103025","url":null,"abstract":"<div><h3>Background</h3><div>Women with metastatic breast cancer (mBC) are living longer than in prior decades due to advances in treatment. However, risk of cardiovascular disease (CVD) remains understudied in this patient population.</div></div><div><h3>Methods</h3><div>We identified 33,239 women diagnosed with de novo mBC between 2000 and 2020 (aged 20–84, survived ≥1 year) from 17 Surveillance, Epidemiology, and End Results Program registries. We estimated standardized mortality ratios (SMRs) and cumulative incidence, accounting for competing risks, for CVD mortality overall and by key characteristics.</div></div><div><h3>Results</h3><div>Over 3.1 median years of follow-up, 724 women with mBC died of CVD (554 heart disease; 127 cerebrovascular disease; 43 other CVD). Overall, women with mBC had an elevated risk of CVD mortality compared to women in the general population after accounting for age, year, and race/ethnicity (SMR=1.45, 95 % CI=1.34–1.55). SMRs for women with mBC were further elevated among those aged &lt; 50 years at diagnosis (3.48, 95 % CI=2.67–4.46), non-Hispanic Asian American and Pacific Islander and Black women (2.18, 95 % CI=1.60–2.90; 2.14, 95 % CI=1.79–2.52, respectively), more recently diagnosed women (1.57, 95 % CI=1.32–1.86), and those with triple negative tumors (2.51, 95 % CI=1.71–3.57). Among women aged &lt; 50 years, SMRs were further elevated among those recently diagnosed (5.44, 95 % CI=2.90–9.31) and within the first five years after diagnosis (5.02, 95 % CI=3.63–6.76). Approximately 1 in 60 women died from CVD within five years following their mBC diagnosis (cumulative incidence: 1.73 %, 95 % CI=1.58–1.88 %) with the highest cumulative incidence among those aged 50 years or older (2.13 %, 95 % CI=1.95–2.33 %).</div></div><div><h3>Conclusions</h3><div>Women with mBC have significantly elevated CVD mortality and further research is warranted to address this heightened risk.</div></div>","PeriodicalId":56322,"journal":{"name":"Cancer Epidemiology","volume":"101 ","pages":"Article 103025"},"PeriodicalIF":2.3,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147313021","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Estimates of cancer incidence to 2025 in Italy: Numbers and rates","authors":"Sabrina Fabiano ,&nbsp;Viviana Perotti ,&nbsp;Paolo Contiero ,&nbsp;Andrea Tittarelli ,&nbsp;Maria Teresa Pesce ,&nbsp;Stefano Guzzinati ,&nbsp;Fabrizio Stracci ,&nbsp;Diego Serraino ,&nbsp;Walter Mazzucco ,&nbsp;Luigino Dal Maso","doi":"10.1016/j.canep.2026.102990","DOIUrl":"10.1016/j.canep.2026.102990","url":null,"abstract":"<div><h3>Objectives</h3><div>We forecasted the incidence of malignant tumours in Italy in 2025, using the most representative estimates of incidence rates and recent trends in cancer incidence available. A comparison with estimates for 2025 obtained using different assumptions and data sets is also presented.</div></div><div><h3>Methods</h3><div>34 cancer registries (81 % of the Italian population) were used to estimate incidence rate trends in 2013–2017, by cancer types, sex, and age. The stratified incidence rates were projected until 2025 by applying trends in the same strata, using a linear regression model with the calendar year as an independent variable.</div></div><div><h3>Results</h3><div>We estimated 362,100 new cancer cases in Italy in 2025 (182,300 in men, 179,800 in women). Prostate is the most frequent cancer site in men (31,200 cases; age-standardised incidence rates-ASR=92.3 per 100,000), followed by lung (27,100, ASR=80.9), bladder, and colon-rectum (23,000 cases each; ASR=69.0). 55,900 women were estimated to be diagnosed with breast cancer (ASR=159.0 per 100,000), 18,900 with colorectal (ASR=47.0) and 16,400 with lung cancers (ASR=41.0).</div></div><div><h3>Conclusions</h3><div>Our estimates were slightly lower than those based on other assumptions and/or different datasets (i.e., ECIS/GLOBOCAN ones). More effective anti-smoking campaigns are needed to halt the predicted increase in smoking-related cancers among women.</div></div>","PeriodicalId":56322,"journal":{"name":"Cancer Epidemiology","volume":"101 ","pages":"Article 102990"},"PeriodicalIF":2.3,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146159486","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Risk score development for pancreatic cancer in Chinese men: A population-based cohort study","authors":"Jie Cai ,&nbsp;Hongda Chen ,&nbsp;Yuhan Zhang ,&nbsp;Bin Lu ,&nbsp;Ming Lu ,&nbsp;Chenyu Luo ,&nbsp;Lei You ,&nbsp;Min Dai","doi":"10.1016/j.canep.2026.102994","DOIUrl":"10.1016/j.canep.2026.102994","url":null,"abstract":"<div><h3>Background</h3><div>Pancreatic cancer (PC) is a malignant tumor without effective screening methods in the general population. This study aimed to develop a PC risk score to identify men at high risk for PC for early intervention.</div></div><div><h3>Methods</h3><div>Based on a prospective cohort study conducted in China in 2006, 90,402 men with at least two fasting blood glucose (FBG) measurements were included in this study. The PC risk model was developed using Cox regression, including the risk factors for age, total cholesterol, FBG and body mass index (BMI) change rate. The power of discrimination was examined using Harrell’s C-index and time-dependent area under curves (AUCs).</div></div><div><h3>Results</h3><div>During the 10-year follow-up period, 82 men developed PC (total person-years: 821,346). Age, total cholesterol level, FBG and BMI change rate were included in the final PC risk model, with a C-index of 0.754 (95 % CI 0.709–0.799). After internal validation, the AUCs of the model in different years (2, 5, 8, and 10 years) were &gt; 0.700 in all men and in men without diabetes. In the derived scoring system (score range:-2–10), there was an approximately 40 % increased risk (Hazard ratio, 1.415; 95 % CI, 1.291–1.550) with every 1-point increase. Participants with the top 20 % scores (6–10 points) had a 30-fold increased risk of PC compared with individuals in the lowest score group (-2 – -1 points).</div></div><div><h3>Conclusions</h3><div>A scoring system for identifying high-risk men with PC was developed, which may be helpful for early detection and intervention of PC in the future.</div></div>","PeriodicalId":56322,"journal":{"name":"Cancer Epidemiology","volume":"101 ","pages":"Article 102994"},"PeriodicalIF":2.3,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145981930","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cardiovascular disease as a contributing cause of cancer mortality: A population-based analysis of United States death certificate data (1999–2020)","authors":"Sanchit Mehta ,&nbsp;Lovy Arora ,&nbsp;Netra Agarwal ,&nbsp;Asha Khubchandani","doi":"10.1016/j.canep.2026.102991","DOIUrl":"10.1016/j.canep.2026.102991","url":null,"abstract":"<div><h3>Background</h3><div>Emerging evidence suggests a complex bidirectional relationship between cardiovascular disease (CVD) and cancer. However, population-level data characterizing the burden of cardiovascular comorbidities at the time of cancer-attributable death remains limited. We analyzed the association between the presence of cardiovascular disease on death certificates and cancer mortality patterns across demographic groups using national mortality data from 1999 to 2020.</div></div><div><h3>Methods</h3><div>Using CDC WONDER multiple cause-of-death data, we analyzed records of adults ≥ 18 years with cancer as the underlying cause of death. CVD comorbidity was defined as any cardiovascular condition (ICD-10 I00-I99) listed as a contributing cause. We calculated age-adjusted mortality rates (AAMR) per 100,000 population and rate ratios, stratified by demographics and cancer types.</div></div><div><h3>Results</h3><div>Among 13,847,293 cancer deaths, 4521,847 (32.6 %) had cardiovascular disease listed as a contributing cause. The overall AAMR for cancer deaths with CVD was 47.75 per 100,000 (95 % CI: 47.66–47.85). Males showed higher rates than females (62.26 vs 37.22 per 100,000, rate ratio 1.67). Non-Hispanic Black populations had the highest burden (57.10 per 100,000), while Asian/Pacific Islander populations had the lowest (30.80 per 100,000). For lung cancer, mortality rates were substantially higher when CVD was present, with rate ratios ranging from 1.70 to 2.43; however, this association is likely attributable to profound unmeasured confounding by shared risk factors such as smoking.</div></div><div><h3>Conclusions</h3><div>Cardiovascular disease is listed as a contributing factor in nearly one-third of all cancer deaths, with distinct demographic patterns. These findings highlight the significant burden of cardiovascular comorbidities documented on death certificates at the end of life for cancer patients.</div></div>","PeriodicalId":56322,"journal":{"name":"Cancer Epidemiology","volume":"101 ","pages":"Article 102991"},"PeriodicalIF":2.3,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146024976","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}