Mortality Risk Elevated for Long-Term Survivors of Childhood Cancer

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Survivors of childhood cancer have excess risk for late mortality 40 years or more from diagnosis

By Elana Gotkine HealthDay Reporter

WEDNESDAY, April 26, 2023 (HealthDay News) — Survivors of childhood cancer have an excess risk for health-related mortality even 40 years or more from diagnosis, according to a study published online April 5 in The Lancet.

Stephanie B. Dixon, M.D., from St. Jude Children’s Research Hospital in Memphis, Tennessee, and colleagues conducted a retrospective cohort study involving 34,230 five-year survivors of childhood cancer diagnosed at age younger than 21 years from 1970 to 1999 who were followed for a median of 29 years from diagnosis. Demographic, self-reported modifiable lifestyle, and cardiovascular risk factors associated with health-related mortality (excluding death from primary cancer and external causes) were examined.

The researchers found that the 40-year cumulative all-cause mortality was 23.3 percent; 51.2 percent of 5,916 deaths were from health-related causes. Overall, there were 131 excess health-related deaths per 10,000 person-years for survivors 40 years or more from diagnosis, including those due to the top three causes of health-related death in the general population: cancer, heart disease, and cerebrovascular disease (absolute excess risks, 54, 27, and 10 per 10,000 person-years, respectively). Independent of other factors, healthy lifestyle and absence of hypertension and diabetes were each associated with a 20 to 30 percent reduction in health-related mortality.

“Continued reductions in intensity of primary cancer therapy and future research targeting interventions for modifiable lifestyle and cardiovascular risk factors in survivors could offer an opportunity to reduce morbidity and extend the lifespan for survivors,” the authors write.

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