Gatta G, Capocaccia R, Rossi S, Athanasiadou M, Bennett D, Dusek L, Galceran J, Hackl M, Holleczek B, Innos K, Katalinic A, Marcos-Gragera R, Murray D, Schaffar R, Smits S, Smailytė G, Storm H, Vener C, Žagar T, Bernasconi A, Jooste V, Botta L; EUROCARE‐6 WG.
Cancer Med. 2026 Sep;15(9):e72266. doi: 10.1002/cam4.72266.
Abstract
Introduction: Cancer patients may face elevated mortality not only from their malignancy but also from other factors including multi-morbidity and the impact of treatment-related complications. This study analyses mortality from all causes other than the index cancer among cancer patients compared to the general population.
Methods: We analysed EUROCARE-6 data on 1,894,057 cancers diagnosed in 13 European countries and collected by 17 cancer registries with complete official cause-of-death information. Included were first-primary head and neck (H&N), stomach, colorectal, lung, breast, cervical, endometrial, ovarian, prostatic, kidney, and bladder cancers diagnosed between 1998 and 2013 in patients aged 15-79, with follow-up until 31st December 2014. We estimated the relative risk (RR) of death from all other causes for patients relative to population mortality rates. Cause-specific survival (CSS) was compared to relative survival (RS) at 5 and 10 years.
Results: RR were > 2 for H&N and female lung cancers, between 1 and 2 for stomach, male lung, cervix, endometrial, ovary, kidney and bladder, and < 1 for prostate and female breast cancers. Relative risk declined with increasing age for almost all cancer types. Ten-year CSS exceeded RS by 7%-11% points (pp) in H&N cancers, with smaller differences in bladder (2-6 pp), stomach, lung, cervix, ovary and kidney (2-3 pp). CSS was lower than RS in breast and prostate cancers.
Conclusion: Differentiation between deaths due to the index cancer and to all other causes is crucial for patient follow-up and to improve quality of life. Cause-of-death data should be a core component of population-based cancer registries to inform interpretation of survivorship data.