In the setting of a new cancer diagnosis, the focus is usually on the cancer as the main threat to survival, but people may have other conditions that pose an equal or greater threat to their life than their cancer: a competing risk of death. This is especially true for patients who have cancer of the oral cavity, because prolonged exposure to alcohol and tobacco are risk factors for cancer in this location but also can result in medical conditions with the potential to shorten life expectancy, competing as a cause of death that may intervene in conjunction with or before the cancer.
A calculator designed for public use has been released that allows patients age 20 to 86 years who have a newly diagnosed oral cancer to obtain estimates of their health status–adjusted age, life expectancy in the absence of the cancer, and probability of surviving, dying of the cancer, or dying of other causes within 1 to 10 years after diagnosis. The models in the calculator showed that patients with oral cavity cancer had a higher than average risk of death from other causes than the matched US population, and this risk increases by stage.
Conclusions and Relevance
The Surveillance, Epidemiology and End Results Program Oral Cancer Survival Calculator supports a holistic approach to the life of the patient, and the risk of death of other causes is treated equally to consideration of the probability of death of the cancer. This tool may be usefully paired with the other available prognostic calculators for oral cancer and is an example of the possibilities now available with registry linkages to partially overlapping or independent data sets and statistical techniques that allow the use of 2 time scales in 1 analysis.
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CME Disclosure Statement: Unless noted, all individuals in control of content reported no relevant financial relationships. If applicable, all relevant financial relationships have been mitigated.
Accepted for Publication: June 12, 2023.
Published Online: July 10, 2023. doi:10.1001/jamaoto.2023.1977
Corresponding Author: Louise Davies, MD, MS, VA Outcomes Group, 215 N Main St, 111B, White River Junction, VT 05009 (firstname.lastname@example.org).
Author Contributions: Drs Wang and Feuer had full access to all of the data in the manuscript and take responsibility for the integrity of the data and the accuracy of the analysis.
Concept and design: Wang, Scott, Cho, Feuer.
Acquisition, analysis, or interpretation of data: Davies, Hankey, Wang, Zou, Lee, Cho, Feuer.
Drafting of the manuscript: Davies, Wang, Scott, Feuer.
Critical review of the manuscript for important intellectual content: Davies, Hankey, Wang, Zou, Lee, Cho, Feuer.
Statistical analysis: Hankey, Wang, Zou, Lee, Cho, Feuer.
Administrative, technical, or material support: Feuer.
Conflict of Interest Disclosures: Dr Davies reported research support from the National Cancer Institute and the US Department of Veterans Affairs during the conduct of the study. Dr Zou reported personal fees from National Cancer Institute during the conduct of the study and outside the submitted work. No other disclosures were reported.
Funding/Support: This material is based on work supported by the National Cancer Institute Division of Cancer Control and Population Sciences, Surveillance Research Program, and the US Department of Veterans Affairs.
Role of the Funder/Sponsor: The funding organizations had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; and decision to submit the manuscript for publication.
Disclaimers: The views expressed do not necessarily represent the views of the US Department of Veterans Affairs, National Cancer Institute, or the US Government. Also, Dr Davies is Associate Editor of JAMA Otolaryngology–Head & Neck Surgery but was not involved in any of the decisions regarding review of the manuscript or its acceptance.
Meeting Presentation: An early version of this work was presented at the 5th International Conference on Head & Neck Cancer; July 26, 2014; New York, New York. This article was also presented at the AHNS 11th International Conference on Head and Neck Cancer; July 10, 2023; Montreal, Quebec, Canada.
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Successful completion of this CME activity, which includes participation in the evaluation component, enables the participant to earn up to:
It is the CME activity provider's responsibility to submit participant completion information to ACCME for the purpose of granting MOC credit.
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