Abstract
Background: Hospitalized cancer patients are nearly 10 times more likely to develop sepsis when compared to patients with no cancer history. We compared the risk of sepsis between cancer survivors and no cancer history participants, and examined whether race was an effect modifier. Methods: We performed a prospective analysis of data from the REasons for Geographic and Racial Differences in Stroke (REGARDS) cohort. We categorized participants as “cancer survivors” or “no cancer history” derived from self-reported responses of being diagnosed with any cancer, excluding non-melanoma skin cancer. We defined sepsis as hospitalization for a serious infection with ≥2 systemic inflammatory response syndrome criteria. We performed Cox proportional hazard models to examine the risk of sepsis after cancer (adjusted for sociodemographics, health behaviors, and comorbidities), and stratified by race. Results: Among 29,693 eligible participants, 2959 (9.97%) were cancer survivors, and 26,734 (90.03%) were no cancer history participants. Among 1393 sepsis events, the risk of sepsis was higher for cancer survivors (adjusted HR: 2.61, 95% CI: 2.29–2.98) when compared to no cancer history participants. Risk of sepsis after cancer survivorship was similar for Black and White participants (p value for race and cancer interaction = 0.63). Conclusion: In this prospective cohort of community-dwelling adults we observed that cancer survivors had more than a 2.5-fold increased risk of sepsis. Public health efforts should attempt to mitigate sepsis risk by awareness and appropriate treatment (e.g., antibiotic administration) to cancer survivors with suspected infection regardless of the number of years since cancer remission.
| Original language | English |
|---|---|
| Pages (from-to) | 30-38 |
| Number of pages | 9 |
| Journal | Cancer Epidemiology |
| Volume | 55 |
| DOIs | |
| State | Published - Aug 2018 |
Bibliographical note
Funding Information:This work was supported by award {grant number R01-NR012726 } from the National Institute for Nursing Research , {grant number UL1-RR025777 } from the National Center for Research Resources , as well as by grants from the Center for Clinical and Translational Science and the Lister Hill Center for Health Policy of the University of Alabama at Birmingham. The parent REGARDS study was supported by cooperative agreement {grant number U01-NS041588 } from the National Institute of Neurological Disorders and Stroke, National Institutes of Health, Department of Health and Human Service . The content is solely the responsibility of the authors and does not necessarily represent the official views of the funding agencies. Representatives of the funding agencies have been involved in the review of the manuscript but not directly involved in the collection, management, analysis or interpretation of the data. The authors thank the other investigators, the staff, and the participants of the REGARDS study for their valuable contributions. A full list of participating REGARDS investigators and institutions can be found at http://www.regardsstudy.org and http://www.regardssepsis.org . Dr. Moore received grant support from {grant R25 CA47888 }, the Cancer Prevention and Control Training Program grant , funded by the National Cancer Institute , National Institutes of Health . Dr. Moore was additionally supported by grant T32190194 (Colditz) and by the foundation for Barnes Jewish Hospital and by Siteman Cancer Center . The content is solely the responsibility of the authors and does not necessarily represent the official views of the funding agencies.
Publisher Copyright:
© 2018 The Authors
Keywords
- Cancer survivors
- Community-dwelling
- Infection
- Racial disparities
- Sepsis
- Survival analysis
ASJC Scopus subject areas
- Epidemiology
- Oncology
- Cancer Research
