Survivors of the 10 most common cancers diagnosed in adolescents and young adults (AYAs) are at considerably higher risk for diseases in the 12 main diagnostic groups, a study published online ahead of print in the journal JAMA Oncology has shown.1
Although survivors of AYA cancers are at risk for treatment-induced late adverse effects, their long-term risk of hospitalization has not been thoroughly evaluated. The researchers sought to examine relative and absolute excess risk for hospitalizations up to 34 years after cancer diagnosis compared with populations comparisons.
The cohort study of 33 555 5-year survivors of AYA cancer with diagnoses made from 1943 through 2004, when they were age 15 to 39 years, and 228 447 population comparisons, matched to the survivors by sex and year of birth, was conducted in Denmark. Using the Danish Patient Register, the researchers followed cancer survivors and comparisons through December 2010.
The researchers identified 53 032 hospitalizations in AYA cancer survivors, with 38 423 expected hospitalizations, which resulted in an overall rate ratio (RR) of 1.38 (95% CI, 1.37-1.39).
Risks were highest for the main diagnostic groups of diseases of blood and blood-forming organs (RR, 2.00; 95% CI, 1.87-2.14), infectious and parasitic diseases (RR, 1.69; 95% CI, 1.61-1.77), and malignant neoplasms (RR, 1.63; 95% CI, 1.59-1.68).
Overall absolute excess risk (AER) was 2803 (95% CI, 2712-2893) per 100 000 person-years; highest AERs were found for malignant neoplasms, diseases of digestive organs, and diseases of the circulatory system (18%, 15%, and 14% of total AER, respectively).
Survivors of leukemia (RR, 2.21; 95% CI, 2.02-2.42), brain cancer (RR, 1.93; 95% CI, 1.86-2.00), and Hodgkin lymphoma (RR, 1.87; 95% CI, 1.80-1.94) were at highest risk.
“The findings underscore a great diversity of cancer-related health problems that physicians and patients should be knowledgeable about,” reported the authors.
1. Rugbjerg K, Olsen JH. Long-term risk of hospitalization for somatic diseases in survivors of adolescent or young adult cancer [published online ahead of print November 19, 2015]. doi:10.1001/jamaoncol.2015.4393.