Morbidity and mortality among children, adolescents, and young adults with cancer over six decades: a Swedish population-based cohort study (the Rebuc study).

Autor:	Stenmarker M; Department of Oncology, Department of Biomedical Sciences and Clinical Sciences, Linkoping University, Linkoping, Sweden.; Department of Paediatrics, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.; Department of Paediatrics, Futurum Academy for Health and Care, Region Jonkoping County, Sweden., Mallios P; Department of Cardiology and Department of Health, Medicine and Caring Sciences, Linkoping University, Norrkoping, Sweden., Hedayati E; Department of Oncology-Pathology, Karolinska Institutet, Stockholm, Sweden.; Medical Unit: Breast, Endocrine Tumours, and Sarcoma, Theme Cancer, Karolinska University Hospital and Karolinska Comprehensive Cancer Centre, Stockholm, Sweden., Rodriguez-Wallberg KA; Department of Oncology-Pathology, Karolinska Institutet, Stockholm, Sweden.; Department of Reproductive Medicine, Division of Gynecology and Reproduction, Karolinska University Hospital, Stockholm, Sweden., Johnsson A; Department of Oncology-Pathology, Karolinska Institutet, Stockholm, Sweden., Alfredsson J; Department of Cardiology and Department of Health, Medicine and Caring Sciences, Linkoping University, Linkoping, Sweden., Ekman B; Department of Endocrinology in Linkoping, Department of Internal Medicine in Norrkoping, and Department of Health, Medicine and Caring Sciences, Linkoping University, Linkoping, Sweden., Legert KG; Department of Dental Medicine, Karolinska Institutet, Stockholm, Sweden., Borland M; Institute of Neuroscience and Physiology, Department of Health and Rehabilitation/Physiotherapy, Sahlgrenska Academy, University of Gothenburg, SV Hospital Group Rehabilitation Centre, Alingsas Hospital, Alingsas, Sweden., Mellergård J; Department of Neurology in Linkoping, and Department of Biomedical and Clinical Sciences, Linkoping University, Linkoping, Sweden., Eriksson M; Department of Ophthalmology and Department of Biomedical and Clinical Sciences, Linkoping University, Linkoping, Sweden., Marteinsdottir I; Department of Medicine and Optometry, Faculty of Health and Life Sciences, Linnaeus University, Kalmar, Sweden., Davidson T; Department of Health, Medicine and Caring Sciences, Linkoping University, Linkoping, Sweden., Engerström L; Department of Anesthesia and Intensive Care in Norrkoping and Department of Medical and Health Sciences, Linkoping University, Sweden., Sandsveden M; Department of Surgery and Department of Biomedical and Clinical Sciences, Linkoping University Norrkoping, Sweden., Keskisärkkä R; Department of Computer and Information Science, Linkoping University, Linkoping, Sweden., Singull M; Department of Mathematics, Linkoping University, Linkoping, Sweden., Hubbert L; Department of Cardiology and Department of Health, Medicine and Caring Sciences, Linkoping University, Norrkoping, Sweden.
Jazyk:	angličtina
Zdroj:	The Lancet regional health. Europe [Lancet Reg Health Eur] 2024 May 15; Vol. 42, pp. 100925. Date of Electronic Publication: 2024 May 15 (Print Publication: 2024).
DOI:	10.1016/j.lanepe.2024.100925
Abstrakt:	Background: Despite progress in managing cancer in children, adolescents, and young adults (CAYAs), persistent complications may impact their quality of life. This study covers the morbidity and mortality, among CAYAs, with the aim to investigate the influence of socioeconomic factors on outcomes. Methods: This retrospective matched cohort study included the entire Swedish population of individuals under 25 with cancer 1958-2021. The population was identified from the Cancer Register, and controls were paired 1:5 based on age, sex, and residence. Multiple registers provided data on morbidity, mortality, and demographics. Findings: This survey covering 63 years, identified 65,173 CAYAs and matched controls, a total of 378,108 individuals (74% females). CAYAs exhibited a 3.04-times higher risk for subsequent cancer (Odds ratio (OR) 95% confidence interval (CI) 2.92-3.17, p < 0.0001), a 1.23-times higher risk for cardiovascular disease (OR 95% CI 1.20-1.26, p < 0.0001), and a 1.41-times higher risk for external affliction (OR 95% CI 1.34-1.49, p < 0.0001). CAYAs had a higher mortality hazard, and after adjusting for socioeconomic factors, males, individuals born outside Europe, and those with greater sick-leave had a higher association with mortality, while education and marriage showed a beneficial association. Interpretation: The Rebuc study, showed an increased risk for serious complications among young cancer patients in Sweden. Patient-specific variables, demographics, and socioeconomic factors influenced mortality. These results underscore the impact of cancer on the health and lifespan of young individuals and the necessity for further research to address socioeconomic disparities in cancer care. Funding: Grants from the Medical Research Council of Southeast Sweden (FORSS), ALF Grants, Region Ostergotland, and The Swedish Childhood Cancer Fund. Competing Interests: EH is Co-Founder and board member of MedTech-company TrueDose AB, producing at-home blood sampling kits. EH has received speaker's and consultancy fees from Bristol-Myers Squibb, Pfizer, and Amgen. KRW reports unrelated speaker's and consultancy fees from Roche, Pfizer, Organon, Ibsa, Merck and Ferring pharmaceuticals and unrelated grants from Novo Nordisk and Ferring. LE is a board member of the Swedish Intensive Care Register. JA has received lecture fees from Boehringer Ingelheim, Astra Zeneca, MSD, Bayer and Novartis (modest) and advisory board reimbursement from Astra Zeneca and Bayer (modest). He is chair of the board of SWEDEHEART ACS register and the SWEDEHEART Register Research Council and member of the SWEDEHEART steering committee. JM is unpaid member of the board of the Swedish Multiple Sclerosis Society. ME reports unrelated consultation fees from Bayer, Thea Pharma and Novartis. LH reports unrelated modest consultation fees from Astellas, Bayer, and Orion Pharma. All remaining authors declare that they have no conflict of interest. (© 2024 The Author(s).)
Databáze:	MEDLINE
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