Your Risk of Dying, Quantified

Researchers chart your chances, putting odds in context

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HealthDay Reporter

TUESDAY, June 4, 2002 (HealthDayNews) -- You're a 45-year-old man who doesn't smoke. What are your chances of dying in the next 10 years, and should you be more concerned about cancer than other diseases?

A new chart may help you calculate your odds, and perhaps put you at ease. It was developed by researchers who believe that death figures from cancer -- 180,000 lives a year lost to lung cancer, for example -- get lost in context, especially when compared with other ailments.

So, if you're that 45-year-old nonsmoking man, the chart places your odds thusly: seven in 1,000 that you'll die of a heart attack, one in 1,000 that you'll die of a stroke, one in 1,000 that you'll die of lung cancer, one in 1,000 that you'll die of colon cancer, one in 1,000 that you'll die of pneumonia, one in 1,000 that you'll die of AIDS, and five in 1,000 that an accident will kill you.

In all, the odds that you'll die in the next decade are 39 in 1,000.

You're a 45-year-old woman who does smoke. The chance that you'll die of a heart attack in the next 10 years is six in 1,000. It's four in 1,000 for stroke, 10 in 1,000 for lung cancer, four in 1,000 for breast cancer, one in 1,000 for colon cancer, one in 1,000 for ovarian cancer, one in 1,000 for cervical cancer, one in 1,000 for AIDS, one in 1,000 for pneumonia, and two in 1,000 for accidental death. In all, the odds that you'll die in the next decade are 50 in 1,000.

Those numbers, collected and collated by three scholars at Dartmouth Medical School, come from a set of tables appearing in tomorrow's issue of the Journal of the National Cancer Institute. The tables run from age 20 to age 90, and list decade-by-decade risks for three cancers in men (lung, colon, prostate), five cancers in women (lung, breast, colon, ovarian, cervical), as well as for other leading causes of death.

That's what makes these tables unusual, says Dr. Lisa M. Schwartz, a research associate at the Department of Veterans Affairs Medical Center in White River Junction, Vt., and an assistant professor of medicine at Dartmouth who helped gather and publish the information.

"Commonly what happens is that people talk about risk in terms of one disease," she says. "But it's hard to judge the risk of one disease when you can't judge the risk of others or overall risk. This report puts information about one disease in the context of other diseases. It's about putting cancer risk in the context of other conditions."

The report has four risk tables -- two for smokers, two for nonsmokers. Smoking gets special attention, Schwartz says, because "it is a big risk factor for multiple diseases, and thus has a big impact."

How big an impact? A 60-year-old man who has never smoked has a 14.6 percent risk of dying from all causes over the next decade. For a smoker of the same age, the risk is 34.1 percent. For 60-year-old women, the 10-year risk of death is 10.5 percent for nonsmokers, 19.9 percent for smokers.

The idea is to personalize the risk, Schwartz says: "In general, when you read an article, you see a lot of big numbers -- 20,000 deaths a year from this condition, 30,000 deaths a year from that one," she says. "People can overstate the risks because they see big numbers all the time."

However, there's one problem about getting information about someone of your age, sex, and smoking habits. At the moment, the data are available only in the journal report. "We hope to put it in electronic format, but we haven't done it yet," Schwartz says.

You can get some very useful information from the American Cancer Society, says Dr. Michael Thun, head of the society's epidemiological program. The society publishes a lot of numbers in its "Cancer Facts and Figures" report, and those numbers are available on the society's Web site. Those numbers do not include causes of death other than cancer, at least not yet.

"We have been working with a risk communicator who is helping us put similar things up on the Web," Thun says. He can't say when those expanded estimates will become available.

And while the Dartmouth report adds a new dimension to discussion of risk, it has its own limitation, Thun says: "It relates only to the risk of death, not to the hardships you can experience if you become ill but don't die."

What To Do

You can get cancer statistics from the American Cancer Society. (You'll need Adobe Acrobat Reader to download the numbers.)

Note that you have a category of your own if you smoke; smoking is the leading preventable cause of death. Want to quit? Visit the American Lung Association for help.

SOURCES: Lisa M. Schwartz, M.D., research associate, Department of Veterans Affairs Medical Center, White River Junction, Vt.; Michael Thun, director, American Cancer society epidemiological program, Atlanta; June 5, 2002, Journal of the National Cancer Institute

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