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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 LU ; Bagnasco, Francesca ; Bardi, Edit ; De Vathaire, Florent ; Essiaf, Samira ; Winther, Jeanette Falck and Frey, Eva , et al. (2022) In International Journal of Cancer 150(3). p.406-419
Abstract

Late mortality of European 5-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 and 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... (More)

Late mortality of European 5-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 and 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 to 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 to 1969, the mortality hazard ratio declined for first neoplasms (P for trend <.0001) and for infections (P <.0001); declines in relative mortality from second neoplasms and cardiovascular causes were less pronounced (P =.1105 and P =.0829, respectively). PanCareSurFup is the largest study with the longest follow-up of late mortality among European childhood and adolescent cancer 5-year survivors, and documents significant mortality declines among European survivors into modern eras. However, continuing excess mortality highlights survivors' long-term care needs.

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organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
cardiovascular, causes of death, European, late mortality, second malignant neoplasms, survivors of childhood cancer
in
International Journal of Cancer
volume
150
issue
3
pages
406 - 419
publisher
John Wiley & Sons Inc.
external identifiers
  • scopus:85117439375
  • pmid:34551126
ISSN
0020-7136
DOI
10.1002/ijc.33817
language
English
LU publication?
yes
id
d9170eae-50a6-4a33-a13e-9b83f5d34d98
date added to LUP
2021-12-09 14:28:12
date last changed
2024-09-08 06:27:13
@article{d9170eae-50a6-4a33-a13e-9b83f5d34d98,
  abstract     = {{<p>Late mortality of European 5-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 and 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 to 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 to 1969, the mortality hazard ratio declined for first neoplasms (P for trend &lt;.0001) and for infections (P &lt;.0001); declines in relative mortality from second neoplasms and cardiovascular causes were less pronounced (P =.1105 and P =.0829, respectively). PanCareSurFup is the largest study with the longest follow-up of late mortality among European childhood and adolescent cancer 5-year survivors, and documents significant mortality declines among European survivors into modern eras. However, continuing excess mortality highlights survivors' long-term care needs.</p>}},
  author       = {{Byrne, Julianne and Schmidtmann, Irene and Rashid, Humayra and Hagberg, Oskar and Bagnasco, Francesca and Bardi, Edit and De Vathaire, Florent and Essiaf, Samira and Winther, Jeanette Falck and Frey, Eva and Gudmundsdottir, Thorgerdur and Haupt, Riccardo and Hawkins, Michael M. and Jakab, Zsuzsanna and Jankovic, Momcilo and Kaatsch, Peter and Kremer, Leontien C.M. and Kuehni, Claudia E. and Harila-Saari, Arja and Levitt, Gill and Reulen, Raoul and Ronckers, Cécile M. and Maule, Milena and Skinner, Roderick and Steliarova-Foucher, Eva and Terenziani, Monica and Zaletel, Lorna Zadravec and Hjorth, Lars and Garwicz, Stanislaw and Grabow, Desiree}},
  issn         = {{0020-7136}},
  keywords     = {{cardiovascular; causes of death; European; late mortality; second malignant neoplasms; survivors of childhood cancer}},
  language     = {{eng}},
  month        = {{02}},
  number       = {{3}},
  pages        = {{406--419}},
  publisher    = {{John Wiley & Sons Inc.}},
  series       = {{International Journal of Cancer}},
  title        = {{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}},
  url          = {{http://dx.doi.org/10.1002/ijc.33817}},
  doi          = {{10.1002/ijc.33817}},
  volume       = {{150}},
  year         = {{2022}},
}