Mortality risks in survivors of childhood cancer

January 01, 0001

Mortality risks in survivors of childhood cancer

Survivors of childhood cancers are known to have increased mortality risk subsequently, but the details of this risk are lacking. These British researchers sought to investigate long-term cause-specific mortality among 5-year survivors of childhood cancer. They utilized the British Childhood Cancer Survivor Study, a population-based cohort of 17,981 5-year survivors of childhood. They measured standardized mortality ratios (SMRs) and absolute excess risks (AERs).

The researchers found: "Overall, 3049 deaths were observed, which was 11 times the number expected (SMR, 10.7). The SMR declined with follow-up but was still 3-fold higher than expected 45 years from diagnosis. The AER for deaths from recurrence declined from 97 extra deaths per 10,000 person-years at 5 to 14 years from diagnosis, to 8 extra deaths beyond 45 years from diagnosis. In contrast, during the same periods of follow-up, the AER for deaths from second primary cancers and circulatory causes increased from 8 extra deaths and 2 extra deaths to 58 extra deaths and 29 extra deaths, respectively. Beyond 45 years from diagnosis, recurrence accounted for 7% of the excess number of deaths observed while second primary cancers and circulatory deaths together accounted for 77%."

The researchers concluded: "Among a cohort of British survivors of childhood cancer, excess mortality from second primary cancers and circulatory diseases continued to occur beyond 25 years from diagnosis."

This large population based cohort study elucidates the ongoing risks of cancer and cardiovascular disease in survivors of childhood cancer.

For the full abstract, click here.

JAMA 304(2):172-179, 14 July 2010 © 2010 the American Medical Association
Long-term Cause-Specific Mortality Among Survivors of Childhood Cancer. Raoul C. Reulen, David L. Winter, Clare Frobisher, et al.

Category: A. General/Unspecified. Keywords: cancer, childhood cancer, primary cancer, cardiovascular disease, mortality, population based cohort study, journal watch.
Synopsis edited by Dr Paul Schaefer, Toledo, Ohio. Posted on Global Family Doctor 3rd August 2010

Pearls are an independent product of the Cochrane primary care group and are meant for educational use and not to guide clinical care.

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