Chronic obstructive pulmonary disease mortality risk in renal cell carcinoma: A population-based study from 1992-2021.

450 Background: Renal Cell Carcinoma (RCC) is one of the most common malignancies in the United States, with about 82000 new cases and 15000 deaths each year. Over the years, RCC mortality rates have been on a downward trend, and this is attributable to cutting-edge research and treatment modalities; however, non-cancer deaths continue to have an increasing trend. Chronic Obstructive Pulmonary Disease (COPD) plays a significant role in this trend. We holistically evaluated the COPD mortality risk in patients with RCC. Methods: We utilized the Surveillance, Epidemiology, and End Results (SEER) database to retrieve cases of RCC with mortality secondary to COPD from 1992 to 2021. The histologic code for RCC in the SEER database is 8312/3, which is part of the International Classification of Diseases for Oncology, Third Edition (ICD-O-3). We then obtained the standardized mortality rates (SMR) and absolute excess risk (AER). Results: We compared the COPD mortality risk of each group to the general US population and noted significantly increased COPD SMRs. Patients with non-COPD causes of death and patients with unknown age, race and cancer stage were excluded. Regarding race, Non-Hispanic American Indians had the highest risk of COPD mortality (SMR 15.30, CI 3.16-44.71, AER 1029.25), followed by Non-Hispanic Asian/Pacific Islanders (SMR 8.67, CI 5.22-13.55, AER 1781.62), then Hispanics (SMR 3.67, CI 2.63-4.97 994.43), Non-Hispanic Whites (SMR 2.69, CI 2.44-2.95, AER 788.19), Non-Hispanic Blacks (SMR 2.33, CI 1.67-3.16, AER 648.94). Based on cancer stage, distant had the highest risk of COPD mortality (SMR 16.65, CI 9.70-26.65, AER 3985.35) while regional had relatively the lowest risk (SMR 3.62, CI 2.18-5.65, AER 1174.61) with localized (SMR 4.00 CI 3.37-4.72, AER 1572.98). In terms of age, patients aged 40-59 years had an SMR of 5.33 (CI 4.28-6.56, AER 619.66), 60-79 years had an SMR of 2.73 (CI 2.45-3.03, AER 838.76), while 80 years and above had an SMR of 2.00 (CI 1.63-2.43, p<0.05, AER 1261.89). Conclusions: We evaluated the extent of the risk of COPD-related deaths in RCC patients. Compared to the general United States population, patients with RCC have a higher risk of COPD mortality. Therefore, there is a need to improve primary and secondary preventive modalities and modify risk factors in this subset of patients to reduce morbidity and mortality.