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ORIGINAL RESEARCH article

Front. Oncol.
Sec. Cancer Epidemiology and Prevention
Volume 14 - 2024 | doi: 10.3389/fonc.2024.1402217
This article is part of the Research Topic Cancer and inflammatory diseases research: from the basics to the precision medicine View all 11 articles

Association of hemoglobin, albumin, lymphocyte, and platelet score with risk of all-cause and cause-specific mortality among cancer survivors: NHANES 1999-2018

Provisionally accepted
Jixin Fu Jixin Fu 1*Xiaohan Yue Xiaohan Yue 1*Yanan Zou Yanan Zou 1Jian Zhang Jian Zhang 2*Xinjian Wang Xinjian Wang 1*Dianliang Zhang Dianliang Zhang 3*
  • 1 Weihai Central Hospital, Weihai, Shandong, China
  • 2 The Affiliated Hospital of Qingdao University, Qingdao, Shandong Province, China
  • 3 Qingdao Municipal Hospital, Qingdao University Medical College, Qingdao, Shandong Province, China

The final, formatted version of the article will be published soon.

    The HALP score, comprising hemoglobin, albumin, lymphocyte, and platelet levels, serves as an indicator of both nutritional and inflammatory status.However, its correlation with all-cause and cause-specific mortality among cancer survivors remains unclear. Therefore, this study aims to investigate the relationship between HALP scores and mortality outcomes in this population.We extracted cohort data spanning ten cycles (1999-2018) from the U.S.National Health and Nutrition Examination Survey (NHANES). Mortality rates, determined using the National Death Index (NDI) as of December 31, 2019, were assessed. Weighted multivariate logistic regression analyzed the association between HALP scores and cancer prevalence. Kaplan-Meier analyses and weighted multivariate-adjusted Cox analyses investigated the link between HALP scores and all-cause and cause-specific mortality in cancer survivors. Restricted cubic spline (RCS) analysis was employed to assess nonlinear relationships. Furthermore, multi-parametric subgroup analyses were conducted to ensure the robustness of the results.Results: Our study included 41,231 participants, of whom 3,786 were cancer survivors (prevalence: 9.5%). Over a median follow-up of 91 months (range: 51-136), we observed 1,339 deaths, including 397 from cancer, 368 from cardio-cerebrovascular disease, and 105 from respiratory disease. Elevated HALP scores showed a consistent association with reduced cancer incidence (P for trend <0.001). In multivariable-adjusted Cox regression analyses, HALP scores were significantly inversely associated with all-cause mortality, cancer mortality, cardio-cerebrovascular disease mortality, and respiratory disease mortality in cancer survivors (P for trend < 0.05). Nonlinear relationships between HALP scores and all-cause and cause-specific mortality in cancer survivors were evident through RCS regression modeling (P for nonlinearity < 0.01). Kaplan-Meier analyses demonstrated that higher HALP scores were indicative of a poorer prognosis.Our findings indicate a notable inverse correlation between HALP scores and both all-cause and cause-specific mortality among cancer survivors.

    Keywords: cancer survivors, HALP score, All-cause mortality, Cause-specific mortality, National Health and Nutrition Examination Survey

    Received: 17 Mar 2024; Accepted: 30 Aug 2024.

    Copyright: © 2024 Fu, Yue, Zou, Zhang, Wang and Zhang. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence:
    Jixin Fu, Weihai Central Hospital, Weihai, Shandong, China
    Xiaohan Yue, Weihai Central Hospital, Weihai, Shandong, China
    Jian Zhang, The Affiliated Hospital of Qingdao University, Qingdao, 266000, Shandong Province, China
    Xinjian Wang, Weihai Central Hospital, Weihai, Shandong, China
    Dianliang Zhang, Qingdao Municipal Hospital, Qingdao University Medical College, Qingdao, 266021, Shandong Province, China

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