Laboratory and biometric predictors of cancer-related mortality in an insured population.

Objectives: Identification of statistically significant laboratory and biometric predictors of cancer-related mortality among insured individuals.

Background: Numerous clinical studies have identified correlations between various laboratory results and physical measurements and cancer risk, often of a uni-variate nature. A study of life insurance claims has permitted a broad multivariate analysis of laboratory and biometric risk factors for cancer mortality in an insured population.

Methods: Of the applicants with complete laboratory and physical measurement profiles, 1.25 million were available and followed for an average of 4.7 years. Dates of 518 life insurance claims resulting from cancer deaths were recorded, and the resulting data set analyzed by multivariate Cox Proportional Hazards regression to identify statistically significant predictors of cancer-related mortality among insured individuals.

Results: Among demographic variables, cancer deaths were found to be strongly associated with age and tobacco use, but not with gender. Among serum and urine analytes, liver function tests (principally GGT and ALP), hypocholesterolemia, proteinurea, and low fructosamine were found to be independently predictive of cancer mortality. Among physical measurement variables, there was a positive relationship between cancer mortality risk and height and relatively weak relationships with pulse and blood pressure. Weight and body mass index (BMI) were not statistically significant covariates.

Conclusions: The findings highlight the potential value of laboratory analytes and biometric measurements to cancer risk assessment including low to low-normal values in analytes (particularly cholesterol and fructosamine) whose diagnostic value in clinical practice and underwriting may be advantageous.