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@ARTICLE{DavilaBatista:300178,
      author       = {V. Davila-Batista and V. Viallon and E. Fontvieille and A.
                      Jansana and M. Kohls and N. P. Bondonno and A. Tjønneland
                      and C. C. Dahm and C. S. Antoniussen and V. Katzke$^*$ and
                      R. Bajrachaya and M. B. Schulze and C. Agnoli and F. Ricceri
                      and S. Panico and R. Zamora-Ros and M. Rodriguez-Barranco
                      and P. Amiano and M.-D. Chirlaque and C. Moreno-Iribas and
                      K. Papier and K. K. Tsilidis and D. Aune and M. J. Gunter
                      and E. Weiderpass and M. Jenab and P. Ferrari and H.
                      Freisling},
      title        = {{A}ssociations between cardiometabolic comorbidities and
                      mortality in adults with cancer: multinational cohort
                      study.},
      journal      = {BMJ medicine},
      volume       = {4},
      number       = {1},
      issn         = {2754-0413},
      address      = {[London]},
      publisher    = {BMJ Publishing Group Ltd.},
      reportid     = {DKFZ-2025-00655},
      pages        = {e000909},
      year         = {2025},
      abstract     = {To examine separate and joint associations between
                      pre-existing cardiometabolic comorbidities and all cause and
                      cause specific mortality in adults with cancer.Multinational
                      cohort study.Seven European countries from the European
                      Prospective Investigation into Cancer and Nutrition (EPIC)
                      study, 1 January 1992 to 31 December 2013.26 987
                      participants $(54\%$ women) who developed a first primary
                      cancer. 2113 had a history of type 2 diabetes, 1529 had a
                      history of cardiovascular disease, and 531 had a history of
                      both, at the time of diagnosis of cancer.Hazard ratios
                      $(95\%$ confidence intervals, CIs) for associations between
                      pre-existing cardiometabolic comorbidities and all cause and
                      cause specific mortality in adults with cancer, estimated
                      with multivariable Cox regression models. Associations were
                      also estimated by groups of five year relative survival of
                      cancer (survival $≤40\%,$ $40-80\%,$ and $≥80\%)$
                      according to Surveillance, Epidemiology, and End Results
                      (SEER) statistics, and for the most common site specific
                      cancers.At the time of diagnosis of cancer, $84.5\%$ (n=22
                      814) of participants had no history of a cardiometabolic
                      disease, $7.8\%$ (n=2113) had a history of type 2 diabetes,
                      $5.7\%$ (n=1529) had a history of cardiovascular disease,
                      and $2.0\%$ (n=531) had a history of both cardiovascular
                      disease and type 2 diabetes. 12 782 deaths (10 492 cancer
                      deaths) occurred over a mean follow-up period of 7.2 years.
                      After multivariable adjustments, pre-existing comorbidities
                      were positively associated with all cause mortality, with
                      hazard ratios 1.25 $(95\%$ CI 1.17 to 1.34), 1.30 (1.21 to
                      1.39), and 1.60 (1.42 to 1.80) for participants with type 2
                      diabetes, cardiovascular disease, or both, respectively,
                      compared with participants with no cardiometabolic
                      comorbidity. Corresponding hazard ratios for cancer specific
                      mortality were 1.13 $(95\%$ CI 1.05 to 1.22), 1.13 (1.04 to
                      1.23), and 1.33 (1.16 to 1.53), respectively. Associations
                      for all cause mortality were stronger among participants
                      with cancers with a five year relative survival $≥80\%.$
                      In a subsample, duration of type 2 diabetes
                      (Pinteraction=0.73) or cardiovascular disease
                      (Pinteraction=0.24), categorised as <5 years or ≥5 years,
                      did not modify associations between these comorbidities and
                      all cause mortality.In this study, cardiovascular disease or
                      type 2 diabetes, or a combination of both, before a
                      diagnosis of cancer, was associated with increased mortality
                      (all cause mortality, and cancer and cardiovascular disease
                      specific mortality). These findings support a direct role of
                      cardiometabolic comorbidities on the prognosis of cancer.},
      keywords     = {Diabetes mellitus (Other) / Epidemiology (Other) /
                      Myocardial infarction (Other) / Stroke (Other)},
      cin          = {C020},
      ddc          = {610},
      cid          = {I:(DE-He78)C020-20160331},
      pnm          = {313 - Krebsrisikofaktoren und Prävention (POF4-313)},
      pid          = {G:(DE-HGF)POF4-313},
      typ          = {PUB:(DE-HGF)16},
      pubmed       = {pmid:40151205},
      pmc          = {pmc:PMC11948348},
      doi          = {10.1136/bmjmed-2024-000909},
      url          = {https://inrepo02.dkfz.de/record/300178},
}