In patients with non-metastatic, non-small cell lung cancer (NSCLC), cause of death by comorbidities such as cardiovascular disease (CVD) and chronic obstructive pulmonary disease (COPD) increase with time, according to a study published in Annals of Oncology.

M. L. G. Janssen-Heijnen, PhD, of the VieCuri Medical Centre and fellow researchers from the Netherlands looked at data from 72,021 patients diagnosed with stage I-III NSCLC from 1989 to 2008, which they derived from the Netherlands Cancer Registry.

They matched their findings with the database of Statistics Netherlands in order to identify underlying causes of death, calculating mortality ratios and proportional causes of death during five time periods after diagnosis.

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While lung cancer was the predominant cause of death in the first six years post-diagnosis at 80 to 90 percent for up to three years and 60 to 85 percent up to six years, it decreased proportionally with time, leveling off at 30 percent.

The researchers found that CVD and COPD became more important causes of death thereafter, at 34 percent and 19 percent, respectively. In particular, they were more pronounced in patients who were 60 years of age or older at diagnosis.

“Managing morbidity of these diseases remains relevant,” the authors concluded.


  1. Janssen-Heijnen, M.L.G., et al. “Variation in causes of death in patients with non-small cell lung cancer according to stage and time since diagnosis.” Annals of Oncology. doi: 10.1093/annonc/mdv061. [epub ahead of print]. February 11, 2015.