Cumulative burden of 144 conditions, critical care hospitalisation and premature mortality across 26 adult cancers

Abstract

A comprehensive evaluation of the total burden of morbidity endured by cancer survivors remains unavailable. This study quantified the burden of 144 health conditions and critical care admissions across 26 adult cancers and treatment modalities in 243,767 adults. By age 60, top conditions ranked by fold difference (cumulative burden in survivors divided by cumulative burden in controls) were haematology, immunology/infection and pulmonary conditions. Patients who had all three forms of treatment (chemotherapy, radiotherapy and surgery) experienced a high cumulative burden of late morbidities compared with patients who received radiotherapy alone. The top five cancers with the highest cumulative burden of critical care admissions by age 60 were bone (12.4 events per 100 individuals [CI: 11.6-13.1]), brain (9.0 [7.5-10.5]), spinal cord and nervous system (7.2 [6.7-7.8]), testis (6.7 [4.9-8.4]) and Hodgkin lymphoma (4.4 [3.6-5.1]). Conditions that were associated with high excess years-of-life-lost were haematological conditions (9.6 years), pulmonary conditions (8.6 years) and immunological conditions or infections (7.8 years). As the population of cancer survivors continues to grow, our results indicate that it is important to tackle long-term health consequences through enacting data-driven policies.

Aging and cancer

“…Using data from the UK biobank, the health data from over 240,000 cancer survivors was compared to that of 500,000 adults with no history of cancer after matching by age, sex, and Index of Multiple Deprivation. Late morbidities attributable to cancer included hematological, pulmonary, Immune and renal dysfunctions, and depended on the type, doses and combination of used therapies [ 101 ]. Logically, attempts are underway to palliate these undesired side effects by more appropriate treatments reducing long-term toxicity, screening programs that identify patients at risk of developing specific diseases, as well as by post-therapeutic lifestyle interventions.…”

RAISN: Robot-assisted Indocyanine Green–guided Sentinel Node Biopsy in Clinical Stage I Germ Cell Tumor

“…Among these patients, depending on testicular histology, 20–50% experience recurrence during active surveillance because of occult metastatic disease [2] . Although the overall long-term survival for patients with testicular cancer is very favorable, chemotherapy- and radiotherapy-induced long-term toxicity is associated with a higher incidence of side effects such as cardiovascular events and secondary malignancies [3] , [4] , [5] . Risk-adapted strategies that are based on histological findings for the primary specimen have been adopted to reduce the overall burden of adjuvant treatment.…”