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J Cancer Surviv. 2014 Sep;8(3):460-71. doi: 10.1007/s11764-014-0353-7. Epub 2014 Apr 10.

Noncancer-related mortality risks in adult survivors of pediatric malignancies: the childhood cancer survivor study.

Author information

1
Department of Epidemiology/Cancer Control, St. Jude Children's Research Hospital, 262 Danny Thomas Place, Memphis, TN, 38105-2794, USA, cheryl.cox@stjude.org.

Abstract

PURPOSE:

We sought to identify factors, other than cancer-related treatment and presence/severity of chronic health conditions, which may be associated with late mortality risk among adult survivors of pediatric malignancies.

METHODS:

Using the Childhood Cancer Survivor Study cohort and a case-control design, 445 participants who died from causes other than cancer recurrence/progression or non-health-related events were compared with 7,162 surviving participants matched for primary diagnosis, age at baseline questionnaire, time from diagnosis to baseline questionnaire, and time at-risk. Odds ratios (ORs) and 95 % confidence intervals (CIs) were calculated for overall/cause-specific mortality. Independent measures included number/severity of chronic conditions, medical care, health-related behaviors, and health perceptions/concerns.

RESULTS:

Adjusting for education, income, chemotherapy/radiation exposures, and number/severity of chronic health conditions, an increased risk for all-cause mortality was associated with exercising fewer than 3 days/week (OR = 1.72, CI 1.27-2.34), being underweight (OR = 2.58, CI 1.55-4.28), increased medical care utilization (P < 0.001), and self-reported fair to poor health (P < 0.001). Physical activity was associated with a higher risk of death among males (OR = 3.26, CI 1.90-5.61) reporting no exercise compared to those who exercised ≥3 times per week. Ever consuming alcohol was associated with a reduced risk of all-cause (OR = 0.61, CI 0.41-0.89) and other nonexternal causes of death (OR = 0.40, CI 0.20-0.79). Concerns/worries about future health (OR = 1.54, CI 1.10-2.71) were associated with increased all-cause mortality.

CONCLUSIONS:

Factors independent of cancer treatment and chronic health conditions modify the risk of death among adult survivors of pediatric cancer.

IMPLICATIONS FOR CANCER SURVIVORS:

Continued cohort observation may inform interventions to reduce mortality.

PMID:
24719269
PMCID:
PMC4127349
DOI:
10.1007/s11764-014-0353-7
[Indexed for MEDLINE]
Free PMC Article

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