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Variation in risk for late mortality among pediatric cancer survivors can persist up to 20 years post-diagnosis
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Although all survivors of pediatric cancer face increased risk for death, the risk is reduced as survivors age through childhood and young adulthood, according to study results.
“It is well established that survivors of childhood cancer have an elevated risk for late (>5 years from diagnosis) mortality compared with the general population,” researcher Gregory T. Armstrong, MD, MSCE, associate member in the department of epidemiology and cancer control at St. Jude Children’s Research Hospital and a HemOnc Today editorial board member, told HemOnc Today. “However, the current study utilized a large hospital-based cohort — [the] Childhood Cancer Survivor Study (CCSS) — as well as a large population-based cohort (SEER program) of survivors to identify that, as these children move farther from their primary cancer diagnosis — or at least out to 20 years in the current study — their 5-year mortality risk is progressively reduced.”
Gregory T. Armstrong
Ann C. Mertens, PhD, of the Aflac Cancer and Blood Disorders Center, Armstrong and colleagues evaluated data from 16,602 survivors who were enrolled in the CCSS, as well as 6,576 survivors from the SEER registry.
Patients from the CCSS tended to be younger (median age, 6.8 vs. 11 years) and have different diagnoses (P˂.001) than patients identified through the SEER database. However, the two cohorts were comparable with respect to treatment era and sex.
Results of conditional survival analyses indicated a majority of 5- to 20-year cancer survivors in each diagnosis group were alive in the subsequent 5 years in the CCSS cohort (at least 91.6%) and SEER cohort (at least 91.9%).
Among patients who had survived pediatric cancer for 5 years, the risk for all-cause mortality 15 years after diagnosis was 8.8% in the CCSS cohort and 10.6% in the SEER cohort. Neoplasms were associated with approximately 75% of these deaths.
“These results should reassure parents and children that death from recurrence of the primary cancer is diminished with time,” Armstrong said. “However, future evaluation of conditional mortality beyond 20 years is needed to assess the impact of late-onset chronic medical conditions — including subsequent malignant neoplasms — on late mortality.” – by Alexandra Todak
Disclosure: One researcher reports a consultant role with Sigma-Tau Pharmaceuticals on matters related to acute lymphoblastic leukemia.
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