Back to Search
Start Over
Cause-specific mortality in survivors of adolescent and young adult cancer.
- Source :
-
Cancer [Cancer] 2020 May 15; Vol. 126 (10), pp. 2305-2316. Date of Electronic Publication: 2020 Mar 04. - Publication Year :
- 2020
-
Abstract
- Background: Few studies have adequately addressed long-term survival (>20 years from diagnosis) among survivors of adolescent and young adult (AYA) cancers.<br />Methods: In this retrospective, population-based cohort study in a US integrated health care system, the authors examined cause-specific mortality in 2-year survivors of AYA cancers (patients aged 15-39 years who were diagnosed between 1990 and 2012; N = 10,574) matched (by age, sex, and calendar year) to individuals without cancer (N = 136,683) to determine whether mortality rates changed over time. Incidence rate ratios (IRRs) for mortality were estimated using multivariable Poisson regression. A multivariable Cox model was used to examine predictors of cause-specific mortality among AYA cancer survivors.<br />Results: Through December 31, 2014, 1352 deaths were observed among AYA cancer survivors, yielding an overall survival rate of 78.5% at 25 years after diagnosis. Overall, AYA cancer survivors were at 10.4-fold increased risk for death (95% CI, 9.7-fold to 11.2-fold increased risk for death) compared with the matched noncancer cohort, and this risk remained elevated at >20 years after diagnosis (IRR, 2.9; 95% CI, 2.0-4.3). The absolute excess risk for death from any cause was 12.7 per 1000 person-years (95% CI, 11.9-13.4 per 1000 person-years). Starting at 15 years after diagnosis, the incidence of second cancer-related mortality exceeded the rate of recurrence-related mortality, and similar trends were observed for deaths from other health-related conditions. The 8-year cumulative incidence of mortality declined over time (before 2000, 12.6%; 2000-2006, 10.1%; after 2006, 7.3%; P < .001), largely because of declines in recurrence-related mortality. Age, sex, race/ethnicity, cancer stage at diagnosis, and cancer treatment predicted cause-specific mortality.<br />Conclusions: The current data highlight the need for specialized, long-term follow-up care for AYA cancer survivors.<br /> (© 2020 American Cancer Society.)
- Subjects :
- Adolescent
Adult
Case-Control Studies
Cause of Death
Delivery of Health Care, Integrated
Female
Humans
Incidence
Male
Retrospective Studies
Survival Rate
United States epidemiology
Young Adult
Cancer Survivors statistics & numerical data
Neoplasm Recurrence, Local mortality
Neoplasms, Second Primary mortality
Subjects
Details
- Language :
- English
- ISSN :
- 1097-0142
- Volume :
- 126
- Issue :
- 10
- Database :
- MEDLINE
- Journal :
- Cancer
- Publication Type :
- Academic Journal
- Accession number :
- 32129881
- Full Text :
- https://doi.org/10.1002/cncr.32775