Smith, L orcid.org/0000-0002-4280-6323, Glaser, AW, Greenwood, DC orcid.org/0000-0001-7035-3096 et al. (1 more author) (2020) Cumulative burden of subsequent neoplasms, cardiovascular and respiratory morbidity in young people surviving cancer. Cancer Epidemiology, 66. 101711. ISSN 1877-7821
Abstract
Background: Long-term childhood and young adult cancer survivors are at increased risk of the late effects of multiple chronic conditions. In this study we estimate the cumulative burden of subsequent malignant neoplasms (SMN), cardiovascular and respiratory hospitalisations in long-term survivors of childhood and young adult cancers and associated treatment risks.
Methods: Five-year survivors of cancer diagnosed aged 0–29 years between 1992–2009 in Yorkshire, UK were included. The cumulative count of all hospital admissions (including readmissions) for cardiovascular and respiratory conditions and all SMNs diagnosed up to 2015 was calculated, with death as a competing risk. Associations between treatment exposures and cumulative burden were investigated using multiple-failure time survival models.
Results: A total of 3464 5-year survivors were included with a median follow-up of 8.2 years (IQR 4–13 years). Ten-years post diagnosis, the cumulative incidence for a respiratory admission was 6.0 % (95 %CI 5.2–6.9), a cardiovascular admission was 2.0 % (95 %CI 1.5–2.5), and SMN was 1.0 % (95 % CI 0.7–1.4) with an average of 13 events per 100 survivors observed (95 %CI 11–15). The risk of experiencing multiple events was higher for those treated with chemotherapy drugs with known lung toxicity (HR = 1.35, 95 %CI 1.09–1.68).
Discussion: Survivors of childhood and young adult cancer experience a high burden of morbidity due to respiratory, cardiovascular diseases and SMNs up to 20-years post-diagnosis. Statistical methods that capture multiple morbidities and recurrent events are important when quantifying the burden of late effects in young cancer survivors.
Metadata
Item Type: | Article |
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Authors/Creators: |
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Copyright, Publisher and Additional Information: | © 2020 Elsevier Ltd. All rights reserved. This is an author produced version of an article published in Cancer Epidemiology. Uploaded in accordance with the publisher's self-archiving policy. |
Keywords: | Children; Adolescents and young adults; Respiratory; Cardiovascular; Hospitalisation; Subsequent tumours; Late effects |
Dates: |
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Institution: | The University of Leeds |
Academic Units: | The University of Leeds > Faculty of Medicine and Health (Leeds) > Medicine & Health Faculty Office (Leeds) > Leeds Academic Health Partnership (LAHP) The University of Leeds > Faculty of Medicine and Health (Leeds) > School of Medicine (Leeds) > Leeds Institute of Cardiovascular and Metabolic Medicine (LICAMM) > Clinical & Population Science Dept (Leeds) |
Funding Information: | Funder Grant number Laura Crane Trust No Ext Ref Candlelighters No Ext Ref Candlelighters No Ext Ref Given Candlelighters Fellowship Programme |
Depositing User: | Symplectic Publications |
Date Deposited: | 26 Mar 2020 13:48 |
Last Modified: | 09 Apr 2021 00:38 |
Status: | Published |
Publisher: | Elsevier |
Identification Number: | 10.1016/j.canep.2020.101711 |
Open Archives Initiative ID (OAI ID): | oai:eprints.whiterose.ac.uk:158726 |
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