Cause-specific mortality in survivors of adolescent and young adult cancer
Cancer Mar 12, 2020
Armenian SH, et al. - Researchers used a US integrated health care system to perform this retrospective, population-based cohort analysis to assess cause-specific mortality in 2-year survivors of adolescent and young adult (AYA) cancers (patients aged 15-39 years who were diagnosed between 1990 and 2012; N = 10,574) in order to ultimately know if mortality rates shifted over time. The survivors of AYA cancers were matched to people without cancer (N = 136,683) by age, gender, and calendar year. Among AYA cancer survivors, a total of 1,352 deaths were reported through December 31, 2014, yielding an overall survival rate of 78.5% at 25 years post-diagnosis. A 10.4-fold increased risk for mortality was reported in AYA cancer survivors vs the matched noncancer cohort, and this risk continued to be high at > 20 years post-diagnosis. The absolute excess risk for death from any cause was estimated to be 12.7 per 1000 person-years. Over time reduction in the 8-year cumulative incidence of mortality was documented (before 2000, 12.6%; 2000-2006, 10.1%; after 2006, 7.3%), largely due to reductions in recurrence-related mortality. The cause-specific mortality was predicted by age, gender, race/ethnicity, cancer stage at diagnosis, and cancer treatment. The requirement for specialized, long-term follow-up care for AYA cancer survivors was emphasized by the current data.
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