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Death during adulthood in survivors of childhood and adolescent cancer

✍ Scribed by H. Stacy Nicholson; Thomas R. Fears; Julianne Byrne

Publisher
John Wiley and Sons
Year
1994
Tongue
English
Weight
772 KB
Volume
73
Category
Article
ISSN
0008-543X

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✦ Synopsis

Background. Therapeutic advances have extended survival for most children and adolescents with cancer beyond 5 years from diagnosis. However, excess mortality continues beyond 5 years, and a significant portion results from causes other than the primary cancer. Risk factors for these deaths are not currently known. Thus, the authors studied mortality in a cohort of adult survivors of childhood and adolescent cancer to determine whether survivor characteristics were associated with increased relative risk of death from other causes.

Methods. Using 3255 siblings as control subjects, the authors studied survival in a retrospective cohort study of 2319 adults who were at least !&year survivors of cancer diagnosed before reaching 20 years of age and between 1945 and 1974 (the NCI Five Center Study). Follow-up occurred between 1980 and 1983 at a mean survivor age of 32 years (range, 21-55 years).

Results. Between cohort entry and follow-up, 292 (13%) survivors and 50 (2%) controls died. One-third of the deaths in survivors were from causes other than the primary malignancy. Compared with control subjects, between ages 21 and 40 years, survivors had a more than threefold risk of death from other causes. The relative risk (RR) for death from other causes was greatest for survivors treated with radiation and alkylating agents (RR = 6.1; 95% confidence interval [CI], 3.0-12.4) and for those

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