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, JulianneJulianneByrneSchmidtmann, IreneIreneSchmidtmannRashid, HumayraHumayraRashidHagberg, OskarOskarHagbergBagnasco, FrancescaFrancescaBagnascoBardi, EditEditBardiDe Vathaire, FlorentFlorentDe VathaireEssiaf, SamiraSamiraEssiafWinther, Jeanette FalckJeanette FalckWintherFrey, EvaEvaFreyGudmundsdottir, ThorgerdurThorgerdurGudmundsdottirHaupt, RiccardoRiccardoHauptHawkins, Michael MMichael MHawkinsJakab, ZsuzsannaZsuzsannaJakabJankovic, MomciloMomciloJankovicKaatsch, PeterPeterKaatschKremer, Leontien C MLeontien C MKremerKühni, ClaudiaClaudiaKühniHarila-Saari, ArjaArjaHarila-SaariLevitt, GillGillLevittReulen, RaoulRaoulReulenRonckers, Cécile MCécile MRonckersMaule, MilenaMilenaMauleSkinner, RoderickRoderickSkinnerSteliarova-Foucher, EvaEvaSteliarova-FoucherTerenziani, MonicaMonicaTerenzianiZadravec Zaletel, LornaLornaZadravec ZaletelHjorth, LarsLarsHjorthGarwicz, StanislawStanislawGarwiczGrabow, DesireeDesireeGrabow2024-10-052024-10-052022-02-01https://boris-portal.unibe.ch/handle/20.500.12422/57282Late mortality of European five-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 to 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 60-68 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 1960-69, the mortality hazard ratio declined for first neoplasms (p for trend <0.0001) and for infections (P < 0.0001); declines in relative mortality from second neoplasms and cardiovascular causes were less pronounced (P = 0.1105 and P = 0.0829, respectively). PanCareSurFup is the largest study with the longest follow-up of late mortality among European childhood and adolescent cancer five-year survivors, and documents significant mortality declines among European survivors into modern eras. However, continuing excess mortality highlights survivors' long-term care needs. This article is protected by copyright. All rights reserved.enEuropean cardiovascular causes of death late mortality second malignant neoplasms survivors of childhood cancer600 - Technology::610 - Medicine & health300 - Social sciences, sociology & anthropology::360 - Social problems & social servicesImpact of era of diagnosis on cause-specific late mortality among 77 423 five-year European survivors of childhood and adolescent cancer: the PanCareSurFup consortium.article10.48350/1596933455112610.1002/ijc.33817