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.

Byrne, Julianne; Schmidtmann, Irene; Rashid, Humayra; Hagberg, Oskar; Bagnasco, Francesca; Bardi, Edit; De Vathaire, Florent; Essiaf, Samira; Winther, Jeanette Falck; Frey, Eva; Gudmundsdottir, Thorgerdur; Haupt, Riccardo; Hawkins, Michael M; Jakab, Zsuzsanna; Jankovic, Momcilo; Kaatsch, Peter; Kremer, Leontien C M; Kuehni, Claudia E.; Harila-Saari, Arja; Levitt, Gill; ... (2022). 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. International journal of cancer, 150(3), pp. 406-419. Wiley-Blackwell 10.1002/ijc.33817

Preview	Text Byrne_IntJCancer_2021_AAM.pdf - Accepted Version Available under License Publisher holds Copyright. Download (1MB) | Preview
	Text Byrne_IntJCancer_2021_epub.pdf - Published Version Restricted to registered users only Available under License Publisher holds Copyright. Download (1MB)

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.

Interest & Impact

Downloads

110 since deposited on 08 Oct 2021
34 in the past 12 months

Citations

5 Citations in Web of Science ®
6 Citations in Scopus

Search

in Google Scholar™

Services

Actions (login required)

Edit item

Actions (login required)

Edit item