Survivors of adolescent and young adult (AYA) cancers

Using SEER data, conditional relative survival up to 25 years after diagnosis was studied in a cohort of AYA patients (N = 205,954) diagnosed with a first malignant cancer (thyroid, melanoma, testicular, breast, lymphoma, leukemia, and CNS tumors).[41]

Using SEER data, conditional relative survival up to 25 years after diagnosis was studied in a cohort of AYA patients (N = 205,954) diagnosed with a first malignant cancer (thyroid, melanoma, testicular, breast, lymphoma, leukemia, and CNS tumors).[41]

For all cancer types combined, among individuals who survived up to 5 years, the subsequent 5-year relative survival rate exceeded 95% by 7 years after diagnosis.

Using SEER data, conditional relative survival up to 25 years after diagnosis was studied in a cohort of AYA patients (N = 205,954) diagnosed with a first malignant cancer (thyroid, melanoma, testicular, breast, lymphoma, leukemia, and CNS tumors).[41]

Most AYA cancer patients who survived at least 7 years after diagnosis experienced little difference in survival compared with the general population.

Using SEER data, conditional relative survival up to 25 years after diagnosis was studied in a cohort of AYA patients (N = 205,954) diagnosed with a first malignant cancer (thyroid, melanoma, testicular, breast, lymphoma, leukemia, and CNS tumors).[41]

For specific cancer types, including CNS tumors, female breast cancer, Hodgkin lymphoma, and leukemia, evidence of excess mortality risk persisted, or re-emerged, more than 10 years after a cancer diagnosis.

Using SEER data, conditional relative survival up to 25 years after diagnosis was studied in a cohort of AYA patients (N = 205,954) diagnosed with a first malignant cancer (thyroid, melanoma, testicular, breast, lymphoma, leukemia, and CNS tumors).[41]

Conditional relative survival was lowest for AYA patients with CNS tumors, although patients aged 15 to 29 years demonstrated a higher survival rate than did patients aged 30 to 39 years at the time of diagnosis of their CNS tumors.

A separate analysis of 5-year survivors of AYA cancer (aged 15–39 years at diagnosis), also using SEER data (N = 282,969), demonstrated the following:[42]

A separate analysis of 5-year survivors of AYA cancer (aged 15–39 years at diagnosis), also using SEER data (N = 282,969), demonstrated the following:[42]

The 10-year all-cause mortality rate decreased from 8.3% for those diagnosed between 1975 and 1984 to 5.4% for those diagnosed between 2005 and 2011.

A separate analysis of 5-year survivors of AYA cancer (aged 15–39 years at diagnosis), also using SEER data (N = 282,969), demonstrated the following:[42]

The decrease in mortality primarily resulted from fewer deaths from the initial cancer.

CCSS investigators compared chronic health conditions and all-cause and cause-specific mortality among 5,804 survivors of early-AYA cancer survivors (cancer diagnosis, age 15–20 years; median age, 42 years) and 5,804 childhood cancer survivors (cancer diagnosis, age <15 years; median age, 34 years) matched on primary cancer diagnosis.[43]

CCSS investigators compared chronic health conditions and all-cause and cause-specific mortality among 5,804 survivors of early-AYA cancer survivors (cancer diagnosis, age 15–20 years; median age, 42 years) and 5,804 childhood cancer survivors (cancer diagnosis, age <15 years; median age, 34 years) matched on primary cancer diagnosis.[43]

The SMR was 5.9 (95% CI, 5.5–6.2) for early-AYA survivors and 6.2 (95% CI, 5.8–6.6) for younger childhood cancer survivors, compared with the general population.

CCSS investigators compared chronic health conditions and all-cause and cause-specific mortality among 5,804 survivors of early-AYA cancer survivors (cancer diagnosis, age 15–20 years; median age, 42 years) and 5,804 childhood cancer survivors (cancer diagnosis, age <15 years; median age, 34 years) matched on primary cancer diagnosis.[43]

Early-AYA survivors had lower SMRs for death from health-related causes than did childhood cancer survivors (SMR, 4.8 [95% CI, 4.4–5.1] vs. 6.8 [95% CI, 6.2–7.4]), which was primarily evident more than 20 years after cancer diagnosis.

CCSS investigators compared chronic health conditions and all-cause and cause-specific mortality among 5,804 survivors of early-AYA cancer survivors (cancer diagnosis, age 15–20 years; median age, 42 years) and 5,804 childhood cancer survivors (cancer diagnosis, age <15 years; median age, 34 years) matched on primary cancer diagnosis.[43]

Early-AYA and childhood cancer survivors were at greater risk of developing severe and disabling, life-threatening, or fatal (grades 3–5) health conditions than were siblings of the same age (HR, 4.2 [95% CI, 3.7–4.8] for early-AYA and 5.6 [95% CI, 4.9–6.3] for childhood cancer survivors), although the risk was lower for early-AYA survivors than for childhood cancer survivors.

In a retrospective, population-based cohort study from Kaiser Permanente, cause-specific mortality in 2-year survivors (N = 10,574) of AYA cancers (patients aged 13–39 years who were diagnosed between 1990 and 2012) was examined and compared with individuals without cancer.[45]

In a retrospective, population-based cohort study from Kaiser Permanente, cause-specific mortality in 2-year survivors (N = 10,574) of AYA cancers (patients aged 13–39 years who were diagnosed between 1990 and 2012) was examined and compared with individuals without cancer.[45]

AYA cancer survivors were at a 10.4-fold increased risk of death compared with the matched noncancer cohort, and this risk remained elevated at more than 20 years after diagnosis (incidence rate ratio [IRR], 2.9).

In a retrospective, population-based cohort study from Kaiser Permanente, cause-specific mortality in 2-year survivors (N = 10,574) of AYA cancers (patients aged 13–39 years who were diagnosed between 1990 and 2012) was examined and compared with individuals without cancer.[45]

Beginning at 15 years after diagnosis, the incidence of second cancer–related mortality exceeded the rate of recurrence-related mortality.

In a retrospective, population-based cohort study from Kaiser Permanente, cause-specific mortality in 2-year survivors (N = 10,574) of AYA cancers (patients aged 13–39 years who were diagnosed between 1990 and 2012) was examined and compared with individuals without cancer.[45]

Mortality risk of suicide was doubled in AYA cancer survivors compared with the noncancer cohort.

Chronic comorbidities were investigated in a retrospective, population-based cohort study of 6,778 2-year AYA cancer survivors diagnosed and monitored at Kaiser Permanente.[46]

Chronic comorbidities were investigated in a retrospective, population-based cohort study of 6,778 2-year AYA cancer survivors diagnosed and monitored at Kaiser Permanente.[46]

Approximately 17% of the survivors developed more than one comorbidity. The most common comorbidities were dyslipidemia (22 per 1,000 person-years), hypertension (16 per 1,000 person-years), diabetes (10 per 1,000 person-years), thyroid disorders (9 per 1,000 person-years), and severe depression or anxiety (8 per 1,000 person-years).

Chronic comorbidities were investigated in a retrospective, population-based cohort study of 6,778 2-year AYA cancer survivors diagnosed and monitored at Kaiser Permanente.[46]

IRRs were higher in survivors than in controls without a history of cancer for avascular necrosis (IRR, 8.25), followed by osteoporosis (IRR, 5.75), joint replacement (IRR, 3.89), stroke (IRR, 3.19), premature ovarian failure (IRR, 2.87), and cardiomyopathy or heart failure (IRR, 2.64).

Chronic comorbidities were investigated in a retrospective, population-based cohort study of 6,778 2-year AYA cancer survivors diagnosed and monitored at Kaiser Permanente.[46]

For survivors of AYA cancer, the prevalence of multiple comorbidities approached 40% at 10 years after index date (a 2-year time point from diagnosis), compared with 20% for those without cancer (P < .001).