Reduced life expectancy in adult survivors of childhood cancer

January 01, 0001

Reduced life expectancy in adult survivors of childhood cancer

These US authors estimated the cumulative effect of disease- and treatment-related mortality risks on survivor life expectancy of adults who survived childhood cancers. They did state-transition modeling to simulate the lifetime clinical course of childhood cancer survivors. They estimated probabilities of risk for death from the original cancer diagnosis, excess mortality from subsequent cancer and cardiac, pulmonary, external, and other complications, and background mortality (age-specific mortality rates for the general population) were estimated over the lifetime of survivors of childhood cancer.

They found: "For a cohort of 5-year survivors aged 15 years who received a diagnosis of cancer at age 10 years, the average lifetime probability was 0.10 for late-recurrence mortality; 0.15 for treatment-related subsequent cancer and death from cardiac, pulmonary, and external causes; and 0.05 for death from other excess risks. Life expectancy for the cohort of persons aged 15 years was 50.6 years, a loss of 10.4 years (17.1%) compared with the general population. Reduction in life expectancy varied by diagnosis, ranging from 4.0 years (6.0%) for kidney tumor survivors to more than 17.8 years (28.0%) for brain and bone tumor survivors, and was sensitive to late- recurrence mortality risk and duration of excess mortality risk."

The authors concluded: "Childhood cancer survivors face considerable mortality during adulthood, with excess risks reducing life expectancy by as much as 28%. Monitoring the health of current survivors and carefully evaluating therapies with known late toxicities in patients with newly diagnosed cancer are needed."

We should be aware of this excess mortality risk for our adult patients who have survived childhood cancers.

For the full abstract, click here.

Ann Intern Med 152(7):409-417, 6 April 2010
© 2010 to the American College of Physicians
A Model-Based Estimate of Cumulative Excess Mortality in Survivors of Childhood Cancer. Jennifer M. Yeh, Larissa Nekhlyudov, Sue J. Goldie, Ann C. Mertens, and Lisa Diller. Correspondence to Dr. Yeh: [email protected]

Category: A. General/Unspecified. Keywords: childhood cancer, survival, mortality, risk, life-expectancy, probabilistic modeling, journal watch.
Synopsis edited by Dr Linda French, Toledo, Ohio. Posted on Global Family Doctor 16 April 2010

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