在老年癌症患者中，合并症与癌症争夺死亡原因。目的是根据转移状态评估癌症死亡率和相关因素。2007 年至 2014 年期间，通过 ELCAPA 前瞻性队列研究纳入了年龄≥70 岁的癌症患者，转诊进行治疗前老年评估 (GA)。根本死因是根据《国际疾病分类》第十版修订版定义的。使用世界卫生组织的定义将死亡原因分类为癌症与其他疾病（例如心血管疾病、传染病等）。使用竞争风险模型。1445 名患者的平均 (SD) 年龄为 80.2 (5.8) 48% 是女性。最常见的肿瘤部位是结直肠（19%）、乳腺（17%）和泌尿系统（15%）； 773 名患者 (49%) 出现转移。经过中位 34 个月的随访后，843 例死亡中，有 706 例死于癌症。非转移性患者的 6 个月和 3 年癌症死亡率 (95% CI) 分别为 12% (9-15) 和 34% (29-38)，而非转移性患者则分别为 43% (39-47) 和 79% (75)。 -82) 分别针对转移性患者。日常生活活动依赖性和合并症与非转移性癌症的 6 个月和 3 年死亡率相关（调整后的亚危险比 [aSHR] = 1.68 [0.99-2.85] 和 1.69 [1.16-2.45]；以及 1.98 [1.08] -3.63] 和 3.38 [1.47-7.76]）和转移性患者（aSHR = 2.81 [2.01-3.93] 和 2.95 [2.14-4.07]；以及 1.63 [1.18-2.25] 和 2.06 [1.39-3.05]） 。定时起床行走测试受损与转移性患者的 6 个月和 3 年癌症死亡率相关（aSHR = 1.5 [1.06-2.12] 和 1.38 [1.06-1.81]，分别）。在非转移性患者 (aSHR = 0.53 [0.29-0.97]) 和转移性患者 (aSHR = 0.71 [0.51-1.00]) 中，肥胖与 3 年癌症死亡呈负相关。大多数患有癌症的老年人转诊接受治疗前治疗GA 死于癌症。老年参数与癌症死亡率独立相关，应在预后评估、决策和护理中予以考虑。© 2023 作者。约翰·威利出版的癌症医学

In older patients with cancer, comorbidities compete with cancer for cause of death. The objectives were to evaluate cancer mortality and factors associated, according to metastatic status.Between 2007 and 2014, patients with cancer aged ≥70 referred for pre-therapeutic geriatric assessment (GA) were included through the ELCAPA prospective cohort study. The underlying cause of death was defined according to the International Classification of Diseases, 10th Revision. The World Health Organisation definition was used to categorise the cause of death as cancer versus another disease (e.g. cardiovascular disease, infectious disease, etc.) Competing risk models were used.Mean (SD) age of the 1445 included patients was 80.2 (5.8) and 48% were women. Most common tumour sites were colorectal (19%), breast (17%) and urinary (15%); 773 patients (49%) had metastases. After a 34-month median follow-up, 706 cancer deaths were observed among 843 deaths. The 6-month and 3-year cancer mortality rates (95% CI) were 12% (9-15) and 34% (29-38) for non-metastatic patients and 43% (39-47) and 79% (75-82) for metastatic patients, respectively. Dependency in activities of daily living and comorbidities were associated with 6-month and 3-year cancer mortality in non-metastatic (adjusted subhazard ratio [aSHR] = 1.68 [0.99-2.85] and 1.69 [1.16-2.45]; and 1.98 [1.08-3.63] and 3.38 [1.47-7.76], respectively) and metastatic patients (aSHR = 2.81 [2.01-3.93] and 2.95 [2.14-4.07]; and 1.63 [1.18-2.25] and 2.06 [1.39-3.05], respectively). Impaired Timed-Get-Up-and-Go test was associated with 6-month and 3-year cancer mortality in metastatic patients (aSHR = 1.5 [1.06-2.12] and 1.38 [1.06-1.81], respectively). Obesity was negatively associated with 3-year cancer death in non-metastatic (aSHR = 0.53 [0.29-0.97]) and metastatic patients (aSHR = 0.71 [0.51-1.00]).The majority of older adults with cancer referred for pre-therapeutic GA die from cancer. Geriatric parameters are independently associated with cancer mortality and should be considered for prognosis assessment, decision-making and care.© 2023 The Authors. Cancer Medicine published by John Wiley & Sons Ltd.