Long-term adverse outcomes following five-year survival of cancer diagnosed before 40 years age

[摘要] Purpose: Survival from childhood, teenage, and young adult cancer has increased substantially, with approximately 80% now surviving at least five-years. However, curative treatments are often associated with adverse late effects. This thesis investigated the risk of late adverse health and social outcomes following five-year survival of cancer diagnosed before age 40 years using the British Childhood Cancer Survivor Study (BCCSS) and Teenage and Young Adult Cancer Survivor Study (TY ACSS). Material and Methods: The BCCSS is a population-based cohort of 34,489 five-year survivors of childhood (<15 years) cancer diagnosed from 1940-2006 in Great Britain. The TY ACSS is a population-based cohort of 200,945 five-year survivors of teenage and young adult (15-39 years) cancer diagnosed from 1971-2006 in England and Wales. Results: Some survivors were found to have increased risks of premature mortality, subsequent primary neoplasms, hospitalizations, poor quality-of-life, and psychosocial limitations. However, for premature mortality, the number of excess deaths is decreasing among those more recently diagnosed for several causes-of-death. Conclusions: Survivors of cancer diagnosed before age 40 are at an increased risk of a range of adverse late effects compared to that expected. The findings reported in this thesis will be useful for risk stratification, updating clinical guidelines, and informing survivors and clinicians.

[发布机构] University:University of Birmingham;Department:School of Health and Population Sciences

[关键词] R Medicine;RA Public aspects of medicine