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Cancer Causes & Control

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01-11-2018 | Original paper

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

Authors: Beth A. Mueller, David R. Doody, Noel S. Weiss, Eric J. Chow

Published in: Cancer Causes & Control | Issue 11/2018

Abstract

Purpose

We examined serious long-term outcomes among childhood cancer survivors using population-based data.

Methods

We used 1982–2014 Washington State data to compare hospitalization and/or death (including cause-specific) during up to 27 years follow-up among all 5+ year childhood cancer survivors < 20 years at diagnosis (n = 3,152) and a sample of comparison children within birth cohorts, with assessment by cancer type and child/family characteristics.

Results

During follow-up (9 years median), 12% of survivors had hospitalizations; 4% died. Greatest absolute risks/1,000 person-years were for hospitalization/deaths due to cancers (8.1), infection (6.2), injuries (6.0), and endocrine/metabolic disorders (5.8). Hazard ratios (HR) and 95% confidence intervals (CI) for hospitalization (2.7, 95% CI 2.4–3.0) and any-cause death (14.7, 95% CI 11.3–19.1) were increased, and for all cause-specific outcomes examined, most notably cancer- (35.1, 95% CI 23.7–51.9), hematological- (6.7, 95% CI 5.3–8.5), nervous system- (6.4, 95% CI 5.2–7.8), and circulatory- (5.2, 95% CI 4.1–6.5) related outcomes. Hospitalizations occurred more often among females and those receiving radiation, with modest differences by urban/rural birth residence and race/ethnicity. Cause-specific outcomes varied by cancer type.

Conclusions

This study suggests increased risks for the rarely-studied outcomes of long-term fracture and injury, and confirms increased risks of selected other conditions among survivors. Multi-state pooling of population-based data would increase the ability to evaluate outcomes for uncommon cancer types and by racial/ethnic groups under-represented in many studies.

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Title: Hospitalization and mortality among pediatric cancer survivors: a population-based study
Authors: Beth A. Mueller
David R. Doody
Noel S. Weiss
Eric J. Chow
Publication date: 01-11-2018
Publisher: Springer International Publishing
Published in: Cancer Causes & Control / Issue 11/2018
Print ISSN: 0957-5243
Electronic ISSN: 1573-7225
DOI: https://doi.org/10.1007/s10552-018-1078-0

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