Noncancer mortality among adolescents and young adults with cancer

Anderson, Chelsea; Lund, Jennifer L.; Weaver, Mark A.; Wood, William A.; Olshan, Andrew F.; Nichols, Hazel B.

doi:10.1002/cncr.32063

Cited by 44 publications

(51 citation statements)

References 28 publications

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“…Another more recently researched cause of mortality for patients with cancer is suicide, with an emphasis on emotional distress and anxiety in particular, although this is understudied 31,35 . Our study confirms previous reports showing that there is a relatively high rate of suicides amount pediatric cancer survivors, particularly for survivors of Hodgkin lymphoma and gonadal germ cell tumors.…”

Section: Discussionsupporting

confidence: 85%

Long‐term causes of death among pediatric patients with cancer

Horn

Stoltzfus

Mackley

et al. 2020

Cancer

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Background The objectives of this study were to characterize the risk of death (1) from the primary cancer vs competing cause of death; and (2) from various causes of death vs the general poplation. The relative risk of death after a pediatric cancer diagnosis versus the general population and the risk of death from a primary cancer diagnosis versus competing causes of death. Methods This retrospective, population‐based study used the Surveillance, Epidemiology, and End Results database (1980‐2015) and included patients aged 0 to 19 years at the time of diagnosis. Observed deaths were calculated; the risk of death versus the general population was assessed with standardized mortality ratios (SMRs). Competing risk models for the cause of death were performed. Results There were 58,356 patients who were diagnosed, and the mortality rate was 22.8%. To assess causes of death, 6996 patients who died during the study period were included (45,580 total person‐years at risk): 5128 (73%) died of their primary cancer, and 1868 (27%) died of a competing cause. Among all patients, the rate of death from the index cancer was higher than the rate of death from another cause within the first 5 years after diagnosis. The risk of death from a nonprimary cancer began to supersede the rate of death from the primary cancer 10 years after diagnosis for patients with germ cell tumors, lymphomas, and sarcomas. SMRs for the primary cancer were highest within the first 5 years after diagnosis for all cancers (SMRs, 100‐50,000; P < .0001). The risk of death from competing causes (heart disease, suicide, and sepsis) was elevated (SMR, >100; P < .001). The risk of dying of heart disease was high, especially for patients with astrocytomas (SMR, 47.84; 95% confidence interval [CI], 27.87‐76.59) and neuroblastomas (SMR, 98.59; 95% CI, 47.28‐181.32). The risk of dying of suicide was high in most patients, particularly for those with osteosarcomas (SMR, 111.40; 95% CI, 2.82‐620.69), Hodgkin lymphomas (SMR, 62.35; 95% CI, 34.89‐102.83), and gonadal germ cell tumors (SMR, 28.97; 95% CI, 12.51‐57.09). Conclusions The cause of death for patients with gonadal germ cell tumors, lymphomas, and sarcomas is more commonly a secondary cancer or noncancerous cause than the primary disease; their risk of death from competing causes (heart disease, suicide, and sepsis) rises throughout life.

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Section: Discussionsupporting

confidence: 85%

Long‐term causes of death among pediatric patients with cancer

Horn

Stoltzfus

Mackley

et al. 2020

Cancer

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“…Previous studies have analyzed the causes of death among patients with different types of cancer [ 9 , 10 ]. Further, several investigations have also reported the causes of death in specific cancer types such as breast cancer, and head and neck cancer [ 11 , 12 ], or among a subgroup of patients such as adolescents and young adults [ 13 ]. Unfortunately, no detailed research has been performed on colorectal cancer.…”

Section: Discussionmentioning

confidence: 99%

Cause of death among patients with colorectal cancer: a population-based study in the United States

Chen¹,

Zheng²,

Wang³

et al. 2020

aging

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“…[17][18][19] One recent study using Surveillance, Epidemiology, and End Results data reported that AYA cancer survivors have a higher risk of death due to infection, cardiovascular disease, and renal disease. 20 Among childhood cancer survivors, the risk of death due to primary cancer recurrence is high within the first 10 years after diagnosis but decreases thereafter, whereas the risk of death due to pulmonary or cardiac causes or to secondary malignancy initially is low but then increases. 21,22 An improved understanding of the ways in which causes of death among AYA cancer survivors change over time is needed to identify the main drivers of improved survival and reduce persistent disparities in long-term survival between AYA cancer survivors and the general population.…”

Section: Discussionmentioning

confidence: 99%

Long‐term survival among 5‐year survivors of adolescent and young adult cancer

Berkman

Livingston

Merriman

et al. 2020

Cancer

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BACKGROUND: Although there are a growing number of survivors of adolescent and young adult (AYA) cancer, to the authors' knowledge the long-term overall survival (OS) patterns for AYA cancer survivors are underreported. The objective of the current study was to assess the long-term survival of AYA cancer survivors and identify factors associated with diminished long-term survival. METHODS: The authors used The University of Texas MD Anderson Cancer Center's tumor registry to identify 5-year survivors of cancer diagnosed as AYAs (ages 15-39 years) between the years 1970 and 2005, and who were alive 5 years after diagnosis. Kaplan-Meier curves were used to estimate OS rates over time, and Cox proportional hazards models were fitted to evaluate the association of covariates with OS. RESULTS: The authors identified 16,728 individuals who were 5-year survivors of cancer and were diagnosed as AYAs with a median follow-up of 20.0 years. The 10-year, 20-year, and 25-year OS rates were 86% (95% confidence interval [95% CI], 85%-86%), 74% (95% CI, 73%-75%), and 68% (95% CI, 67%-68%), respectively, all of which were lower than the age-adjusted estimated survival rates of the general population. Long-term OS improved for AYAs diagnosed between 2000 and 2005 compared with those diagnosed in the prior decades (P < .001). Older age at the time of diagnosis, receipt of radiation, and diagnoses including central nervous system tumors and breast cancer each were associated with diminished long-term survival. CONCLUSIONS: AYA cancer survivors have inferior long-term survival compared with the general population. Studies investigating the prevalence and types of late treatment effects and causes of death among AYA survivors are needed to more accurately identify AYAs who are at highest risk of early or late mortality.

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Noncancer mortality among adolescents and young adults with cancer

Cited by 44 publications

References 28 publications

Long‐term causes of death among pediatric patients with cancer

Long‐term causes of death among pediatric patients with cancer

Cause of death among patients with colorectal cancer: a population-based study in the United States

Long‐term survival among 5‐year survivors of adolescent and young adult cancer

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