6533b852fe1ef96bd12aa446
RESEARCH PRODUCT
Impact of era of diagnosis on cause-specific late mortality among 77 423 five-year European survivors of childhood and adolescent cancer:The PanCareSurFup consortium
Arja Harila-saariRoderick SkinnerRoderick SkinnerJeanette Falck WintherHumayra RashidRiccardo HauptFrancesca BagnascoStanislaw GarwiczEdit BardiEdit BardiLorna Zadravec ZaletelMomcilo JankovicLeontien C. M. KremerPeter KaatschSamira EssiafThorgerdur GudmundsdottirMichael M. HawkinsJulianne ByrneZsuzsanna JakabMonica TerenzianiEva FreyClaudia E. KuehniClaudia E. KuehniCécile M. RonckersMilena MauleGill LevittReulen Raoul CDesiree GrabowEva Steliarova-foucherOskar HagbergIrene SchmidtmannLars HjorthFlorent De Vathairesubject
AdultMaleCancer ResearchSecond NeoplasmsAdolescentAdolescent cancercauses of deathEuropean03 medical and health sciencesYoung Adult0302 clinical medicineCancer SurvivorsCause of DeathMedicineHumans030212 general & internal medicineCause specificChild610 Medicine & healthAgedExcess mortalitybusiness.industrycardiovascularsecond malignant neoplasmsHazard ratioCancersurvivors of childhood cancerMiddle Agedmedicine.diseaseConfidence interval3. Good healthOncologyEuropean; cardiovascular; causes of death; late mortality; second malignant neoplasms; survivors of childhood cancer030220 oncology & carcinogenesisChild Preschoollate mortalityFemaleRisk of deathbusiness360 Social problems & social servicesDemographydescription
Late mortality of European five-year survivors of childhood or adolescent cancer has dropped over the last 60 years, but excess mortality persists. There is little information concerning secular trends in cause-specific mortality among older European survivors. PanCareSurFup pooled data from 12 cancer registries and clinics in 11 European countries from 77 423 five-year survivors of cancer diagnosed before age 21 between 1940 to 2008 followed for an average age of 21 years and a total of 1.27 million person-years to determine their risk of death using cumulative mortality, standardized mortality ratios (SMR), absolute excess risks (AER), and multivariable proportional hazards regression analyses. At the end of follow-up 9166 survivors (11.8%) had died compared to 927 expected (SMR 9.89, 95% confidence interval [95%CI] 9.69-10.09), AER 6.47 per 1000 person-years, (95%CI 6.32-6.62). At 60-68 years of attained age all-cause mortality was still higher than expected (SMR = 2.41, 95%CI 1.90-3.02). Overall cumulative mortality at 25 years from diagnosis dropped from 18.4% (95%CI 16.5-20.4) to 7.3% (95%CI 6.7-8.0) over the observation period. Compared to the diagnosis period 1960-69, the mortality hazard ratio declined for first neoplasms (p for trend <0.0001) and for infections (P < 0.0001); declines in relative mortality from second neoplasms and cardiovascular causes were less pronounced (P = 0.1105 and P = 0.0829, respectively). PanCareSurFup is the largest study with the longest follow-up of late mortality among European childhood and adolescent cancer five-year survivors, and documents significant mortality declines among European survivors into modern eras. However, continuing excess mortality highlights survivors' long-term care needs. This article is protected by copyright. All rights reserved.
| year | journal | country | edition | language |
|---|---|---|---|---|
| 2022-02-01 |