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Decreasing late mortality among five-year survivors of cancer in childhood and adolescence: a population-based study in the Nordic countries

Möller, Torgil R.; Garwicz, Stanislaw LU ; Barlow, Lotti; Falck Winther, Jeanette; Glattre, Eystein; Olafsdottir, Gudridur; Olsen, Jörgen H.; Perfekt, Roland LU ; Ritvanen, Annukka and Sankila, Risto, et al. (2001) In Journal of Clinical Oncology 19(13). p.3173-3181
Abstract
PURPOSE: To assess the risk of death in patients who survive more than 5 years after diagnosis of childhood cancer and to evaluate causes of death in fatal cases. PATIENTS AND METHODS: This was a population-based study in the five Nordic countries (Denmark, Finland, Iceland, Norway, and Sweden) using data of the nationwide cancer registries and the cause-of-death registries. The study cohort included 13,711 patients who were diagnosed with cancer before the age of 20 years between 1960 and 1989 and who survived at least 5 years from diagnosis. By December 31, 1995, 1,422 patients had died, and death certificates were assessed in 1,402. Standardized mortality ratios (SMRs) for validated causes of death were calculated based on 156,046... (More)
PURPOSE: To assess the risk of death in patients who survive more than 5 years after diagnosis of childhood cancer and to evaluate causes of death in fatal cases. PATIENTS AND METHODS: This was a population-based study in the five Nordic countries (Denmark, Finland, Iceland, Norway, and Sweden) using data of the nationwide cancer registries and the cause-of-death registries. The study cohort included 13,711 patients who were diagnosed with cancer before the age of 20 years between 1960 and 1989 and who survived at least 5 years from diagnosis. By December 31, 1995, 1,422 patients had died, and death certificates were assessed in 1,402. Standardized mortality ratios (SMRs) for validated causes of death were calculated based on 156,046 patient-years at risk. RESULTS: The overall SMR was 10.8 (95% confidence interval [CI], 10.3 to 11.5), mainly due to high excess mortality from the primary cancer. SMR for second cancer was 4.9 (95% CI, 3.9 to 5.9) and was 3.1 (95% CI, 2.8 to 3.5) for noncancer death. The pattern of causes of death varied markedly between different groups of primary cancer diagnoses and was highly dependent on time passed since diagnosis. Overall late mortality was significantly lower in patients treated during the most recent period of time, 1980 to 1989, compared with those treated from 1960 to 1979 (hazard ratio, 0.61; 95% CI, 0.54 to 0.70), and there was no increase in rates of death due to cancer treatment. CONCLUSION: Long-term survivors of childhood cancer had an increased mortality rate, mainly dying from primary cancers. However, modern treatments have reduced late cancer mortality without increasing the rate of therapy-related deaths. (Less)
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Journal of Clinical Oncology
volume
19
issue
13
pages
3173 - 3181
publisher
American Society of Clinical Oncology
external identifiers
  • pmid:11432883
  • scopus:0035398565
ISSN
1527-7755
language
English
LU publication?
yes
id
e61db290-81be-4673-acd7-b1239f9343f6 (old id 1120585)
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http://jco.ascopubs.org/cgi/reprint/19/13/3173
date added to LUP
2008-07-08 09:09:30
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2018-03-18 03:39:12
@article{e61db290-81be-4673-acd7-b1239f9343f6,
  abstract     = {PURPOSE: To assess the risk of death in patients who survive more than 5 years after diagnosis of childhood cancer and to evaluate causes of death in fatal cases. PATIENTS AND METHODS: This was a population-based study in the five Nordic countries (Denmark, Finland, Iceland, Norway, and Sweden) using data of the nationwide cancer registries and the cause-of-death registries. The study cohort included 13,711 patients who were diagnosed with cancer before the age of 20 years between 1960 and 1989 and who survived at least 5 years from diagnosis. By December 31, 1995, 1,422 patients had died, and death certificates were assessed in 1,402. Standardized mortality ratios (SMRs) for validated causes of death were calculated based on 156,046 patient-years at risk. RESULTS: The overall SMR was 10.8 (95% confidence interval [CI], 10.3 to 11.5), mainly due to high excess mortality from the primary cancer. SMR for second cancer was 4.9 (95% CI, 3.9 to 5.9) and was 3.1 (95% CI, 2.8 to 3.5) for noncancer death. The pattern of causes of death varied markedly between different groups of primary cancer diagnoses and was highly dependent on time passed since diagnosis. Overall late mortality was significantly lower in patients treated during the most recent period of time, 1980 to 1989, compared with those treated from 1960 to 1979 (hazard ratio, 0.61; 95% CI, 0.54 to 0.70), and there was no increase in rates of death due to cancer treatment. CONCLUSION: Long-term survivors of childhood cancer had an increased mortality rate, mainly dying from primary cancers. However, modern treatments have reduced late cancer mortality without increasing the rate of therapy-related deaths.},
  author       = {Möller, Torgil R. and Garwicz, Stanislaw and Barlow, Lotti and Falck Winther, Jeanette and Glattre, Eystein and Olafsdottir, Gudridur and Olsen, Jörgen H. and Perfekt, Roland and Ritvanen, Annukka and Sankila, Risto and Tulinius, Hrafn},
  issn         = {1527-7755},
  language     = {eng},
  number       = {13},
  pages        = {3173--3181},
  publisher    = {American Society of Clinical Oncology},
  series       = {Journal of Clinical Oncology},
  title        = {Decreasing late mortality among five-year survivors of cancer in childhood and adolescence: a population-based study in the Nordic countries},
  volume       = {19},
  year         = {2001},
}