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Hospitalization and mortality among pediatric cancer survivors: a population-based study

Beth A Mueller1,2, David R Doody3, Noel S Weiss3,4

  • 1Public Health Sciences Division, Fred Hutchinson Cancer Research Center (FHCRC), PO 19024, Mailstop M4-C308, Seattle, WA, USA. bmueller@fhcrc.org.

Cancer Causes & Control : CCC
|September 7, 2018
PubMed

Insights

Childhood cancer survivors face increased risks of hospitalization and death from various causes, including cancer, infection, and injury. Long-term monitoring is crucial for these survivors to manage late effects and improve outcomes.

Area of Science:

  • Oncology
  • Epidemiology
  • Public Health

Background:

  • Childhood cancer survival rates have improved significantly.
  • Long-term health outcomes for childhood cancer survivors require ongoing investigation.
  • Population-based data offers a valuable resource for studying late effects in large survivor cohorts.

Purpose of the Study:

  • To examine serious long-term health outcomes in childhood cancer survivors.
  • To compare hospitalization and mortality rates between survivors and a matched comparison group.
  • To identify specific causes of hospitalization and death among survivors based on cancer type and patient characteristics.

Main Methods:

  • Utilized Washington State population-based data from 1982-2014.
  • Included all childhood cancer survivors diagnosed before age 20 who survived for at least 5 years (n=3,152).
  • Compared outcomes with a sample of children from the same birth cohorts, with follow-up up to 27 years.

Main Results:

  • During a median 9-year follow-up, 12% of survivors were hospitalized and 4% died.
  • Highest risks per 1,000 person-years were for cancer, infection, injuries, and endocrine/metabolic disorders.
  • Survivors had significantly increased hazard ratios for hospitalization (2.7) and all-cause death (14.7), with notable increases for cancer, hematological, nervous system, and circulatory outcomes.

Conclusions:

  • Childhood cancer survivors exhibit elevated risks for long-term conditions, including fractures and injuries.
  • Findings confirm increased risks for other selected health conditions.
  • Pooling multi-state population-based data is recommended to enhance the evaluation of outcomes for rare cancer types and underrepresented racial/ethnic groups.
Abstract

Keywords:
Childhood cancerCohortHospitalizationLate effectsMorbiditySurvivorship

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