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Survivors of young adult cancers face increased hospitalization risk into adulthood
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Survivors of young adult cancers experienced elevated rates of hospitalization compared with cancer-free controls, according to study results.
Hospitalization rates remained above baseline for 20-year survivors of young adult cancers, a finding that suggests a persistent burden, researchers wrote.
“Even when young adults survive cancer, the cancer still has an impact on their lives and their long-term health,” Nancy N. Baxter, MD, PhD, division chief in the department of surgery at St. Michael’s Hospital and associate professor of surgery at University of Toronto, said in a press release. “And this age group still has a lot of life to live.”
Nancy N. Baxter
Limited clinical data exist regarding health care use among survivors of young adult cancers, according to study background.
Baxter and colleagues used the Ontario Cancer Registry to identify 20,275 patients diagnosed with cancer between 1992 and 1999. All patients were between the ages of 20 and 44 years at diagnosis, and they all lived recurrence free for at least 5 years.
Researchers matched the survivor cohort with 101,344 cancer-free controls.
Investigators used hospital discharge information to determine hospitalization rates for the two groups. They also determined the absolute excess rate of hospitalizations for each type of malignancy in survivors per 100 person-years of follow-up.
Median follow-up was 9.93 years (range, 0.005-15.999).
During follow-up, 34.4% (n = 6,948) of survivors required hospitalization (adjusted relative rate [ARR] = 1.51; 95% CI, 1.48-1.54).
Survivors of all cancer types except for melanoma and testicular cancer experienced significantly higher rates of hospitalization than cancer-free controls.
Survivors of several cancer types required hospitalization at more than twice the rate of controls. These cancer types included gastrointestinal cancer (ARR = 2.49; 95% CI, 2.15-2.87), leukemia (ARR = 2.23; 95% CI, 1.92-2.59), urologic cancer (ARR = 2.2; 95% CI, 2.03-2.38), colorectal cancer (ARR = 2.1; 95% CI, 1.93-2.28), brain cancer (ARR = 2.04; 95% CI 1.81-2.28) and lymphoma (ARR = 2.02; 95% CI, 1.91-2.14).
The per-person hospitalization rate significantly declined from 0.22 in the first period examined (5 to 8 years following diagnosis) to 0.15 in the last period examined (18 to 20 years following diagnosis; P < .0001). However, survivors remained significantly more likely to be hospitalized than controls at all time periods (5-8 years: ARR = 1.67; 95% CI, 1.57-1.81; 18-20 years: ARR = 1.22; 95% CI, 1.08-1.37).
The researchers acknowledged the consideration of hospital admittance only — without including family physician visits and other forms of outpatient care — as a limitation of their study. Further, the researchers acknowledged that the survivors included in their study may not have been treated with the most contemporary standards of care, as they received primary treatment in the 1990s.
“Our study identifies populations of survivors at particular risk of hospitalization, as well as the affected organ or tissue systems relating to the hospital admission,” the researchers concluded. “This information would be useful for developers of recommendations or guidelines to counsel survivors of young adult cancers on their future quality of life.” – by Cameron Kelsall
Disclosure: Baxter reports research funding from Pfizer. The other researchers report no relevant financial disclosures.
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