Late mortality among five-year survivors of cancer in childhood and adolescence Differences between the Nordic Countries

Möller, Torgil; Garwicz, Stanislaw; Perfekt, Roland; Barlow, Lotti; Winther, Jeanette Falck; Glattre, Eystein; Olafsdottir, Gudridur H; Olsen, Jørgen H.; Ritvanen, Annukka; Sankila, Risto

doi:10.1080/02841860410002860

Cited by 19 publications

(15 citation statements)

References 10 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The CCSS results are similar to those reported from the Nordic countries, 14 but are in contrast to those more recently reported by the British CCSS for ALL patients diagnosed and treated between 1940 and 1991, in whom a standardized mortality ratio of 21.5 (95% CI: 20.0-23.0) was found for this older cohort of childhood ALL survivors. 15 …”

Section: Late Mortalitycontrasting

confidence: 55%

Late Effects of Acute Lymphoblastic Leukemia Therapy in Patients Diagnosed at 0-20 Years of Age

Robison

2011

Hematology

View full text Add to dashboard Cite

Survival rates for children with acute lymphoblastic leukemia (ALL) have increased dramatically over the past 4 decades, with 5-year survival rates of Ͼ 90% in recent trials. With the increasing number of children and adolescents cured of ALL, identifying and characterizing the occurrence of long-term adverse late effects has become increasingly important. In this young population, successful treatment of ALL is associated with increased risk of adverse outcomes such as late mortality, second neoplasms, chronic health conditions, endocrine dysfunction, and psychological function. Research efforts conducted through large survivor cohorts, such as the Childhood Cancer Survivor Study, are providing new and important insights into the very long-term consequences of ALL therapy, while providing direction for screening recommendations and intervention-based approaches for reducing late morbidity and mortality.

show abstract

Section: Late Mortalitycontrasting

confidence: 55%

Late Effects of Acute Lymphoblastic Leukemia Therapy in Patients Diagnosed at 0-20 Years of Age

Robison

2011

Hematology

View full text Add to dashboard Cite

show abstract

“…This estimate is lower than the SMRs identified from studies in childhood cancer survivors, ranging from 7.5 to 10.8 [5, 6, 10, 20–22]. These studies all focused on survivors of younger age than our study, with diagnoses 0–15 years old in British study [20], 0–20 years old in the Nordic study [5], and 0–21 years old in the CCSS study [6, 21].…”

Section: Discussionmentioning

confidence: 56%

Risk of Late Mortality and Second Malignant Neoplasms among 5-Year Survivors of Young Adult Cancer: A Report of the Childhood, Adolescent, and Young Adult Cancer Survivors Research Program

Zhang

Goddard

Spinelli

et al. 2012

Journal of Cancer Epidemiology

View full text Add to dashboard Cite

We conducted a population-based retrospective study to assess the long-term risks of overall and cause-specific mortality and second malignant neoplasm (SMN) among survivors of young adult cancer compared to the risk in British Columbia (BC) population and to evaluate the effects of demographic and clinical factors on risk. 1248 5-year survivors of young adult cancer diagnosed 1970–1995 between 20 and 24 years of age were identified from the BC Cancer Registry and followed to the end of 2007. Standardized mortality ratios (SMRs) and standardized incidence ratios (SIRs) were calculated. The Cox proportional hazards model was used to estimate the effects of different demographic and disease-related characteristics on the risk of death and SMN. A total of 138 deaths and 62 SMNs were observed during follow-up. The overall SMR was 5.9 (95% CI 4.9–6.9) and the absolute excess risk was 5.3 per 1,000 person-years. The overall SIR was 3.0 (95% CI 2.3–3.8). Treatment with radiation resulted in increased risks of death and SMN. These observed increased risks emphasize the importance of prevention, surveillance, and treatment of late effects in survivors of young adult cancers.

show abstract

“…4,24 The current analysis confirms previously published data demonstrating that more recently treated patients have a significantly lower rate of late mortality attributable to deaths from recurrence or progression of their primary cancer. 10,25-27 What has not been documented previously is the reduced rate of mortality due to death from treatment-related late effects such as subsequent malignancies and cardiopulmonary conditions. Additionally, the results generated from the CCSS cohort, provide evidence that the strategy of reduced treatment exposure to decrease the frequency of late effects is translating into a significant reduction in observed late mortality, extending the lifespan of children and adolescents successfully treated for cancer.…”

Section: Discussionmentioning

confidence: 99%

Reduction in Late Mortality among 5-Year Survivors of Childhood Cancer

et al. 2016

View full text Add to dashboard Cite

Background Previously, eighteen percent of childhood cancer patients who survived five years died within the subsequent 25 years. In recent decades, cancer treatment regimens have been modified with the goal of reducing risk for life-threatening late effects. Methods Late mortality was evaluated in 34,033 five-year survivors of childhood cancer (diagnosed <21 years of age from 1970-1999, median follow-up 21 years, range 5-38). Demographic and disease factors associated with mortality due to health-related causes, which exclude recurrence/progression of the original cancer but include deaths that reflect late effects of cancer therapy, were evaluated using cumulative incidence and piecewise exponential models estimating relative rates (RRs) and 95% confidence intervals (CI). Results 1,618 (41%) of the 3,958 deaths were attributable to health-related causes, including 746 subsequent neoplasm, 241 cardiac, and 137 pulmonary deaths. Reduction in 15-year mortality was observed for all-cause (12.4% to 6.0%, P for trend <0.001) and health-related mortality (3.5% to 2.1%, P for trend <0.001), attributable to reductions in subsequent neoplasm (P<0.001), cardiac (P<0.001) and pulmonary death (P<0.001). Changes in therapy by decade included reduced rates of: cranial radiotherapy for acute lymphoblastic leukemia (1970s 85%, 1980s 51%, 1990s 19%), abdominal radiotherapy for Wilms’ tumor (78%, 53%, 43%), chest radiotherapy for Hodgkin's lymphoma (87%, 79%, 61%), and anthracycline exposure. Reduction in treatment exposure was associated with reduced late mortality among lymphoblastic leukemia and Wilms’ tumor survivors. Conclusion The strategy of lowering therapeutic exposure has successfully translated to an observed decline in late mortality among 5-year survivors of childhood cancer.

show abstract

Late mortality among five-year survivors of cancer in childhood and adolescence Differences between the Nordic Countries

Cited by 19 publications

References 10 publications

Late Effects of Acute Lymphoblastic Leukemia Therapy in Patients Diagnosed at 0-20 Years of Age

Late Effects of Acute Lymphoblastic Leukemia Therapy in Patients Diagnosed at 0-20 Years of Age

Risk of Late Mortality and Second Malignant Neoplasms among 5-Year Survivors of Young Adult Cancer: A Report of the Childhood, Adolescent, and Young Adult Cancer Survivors Research Program

Reduction in Late Mortality among 5-Year Survivors of Childhood Cancer

Contact Info

Product

Resources

About