Risk of Adverse Health and Social Outcomes Up to 50 Years After Wilms Tumor: The British Childhood Cancer Survivor Study
| Autor: | Helen C. Jenkinson, Elaine Sugden, Joyeeta Guha, Kathryn Pritchard-Jones, Julie Kelly, David L. Winter, Miranda M. Fidler, Michael M. Hawkins, Emma R Lancashire, Gill Levitt, Raoul C. Reulen, Clare Frobisher, Kwok Wong |
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| Rok vydání: | 2016 |
| Předmět: |
Adult
Male Cancer Research Pediatrics medicine.medical_specialty Adolescent Adverse outcomes Health Status MEDLINE Childhood Cancer Survivor Study Wilms Tumor 03 medical and health sciences Health services 0302 clinical medicine medicine Humans Survivors 030212 general & internal medicine Educational achievement Child Digestive cancer Aged business.industry Infant Newborn Infant Wilms' tumor Middle Aged medicine.disease Kidney Neoplasms Oncology Child Preschool 030220 oncology & carcinogenesis Female Risk of death Neoplasm Recurrence Local business |
| Zdroj: | Journal of Clinical Oncology. 34:1772-1779 |
| ISSN: | 1527-7755 0732-183X |
| Popis: | Purpose Survivors of Wilms tumor (WT) are at risk for adverse health and social outcomes but risks beyond 30 years from diagnosis remain uncertain. We investigated the risks of adverse outcomes among 5-year survivors of WT, in particular, those between 30 and 50 years from diagnosis. Patients and Methods The British Childhood Cancer Survivor Study includes 1,441 5-year survivors of WT. We investigated cause-specific mortality, risk of subsequent primary neoplasms (SPNs), and, for those who completed a questionnaire, the extent of smoking and drinking, educational achievement, health status, and health service use compared with the general population. Results Cumulative risk of death from all causes, excluding recurrence, increased substantially from 5.4% to 22.7% at 30 years and 50 years, respectively, after WT diagnosis—75% of excess deaths beyond 30 years from diagnosis were attributable to SPNs (50%) and cardiac diseases (25%). Digestive cancer, most frequently bowel, accounted for 41% of excess cancers beyond 30 years. Conclusion Between 30 and 50 years from diagnosis, survivors of WT are at a substantially increased risk of premature mortality, and 75% of excess deaths were accounted for by SPNs and cardiac diseases. Radiotherapy exposure was a risk factor for both outcomes. The proportion of patients with WT who are exposed to radiotherapy has reduced substantially in recent decades because of initiatives such as the SIOP WT 2001 clinical trial, which sought to reduce late effects; however, the majority of current survivors, who are at least 30 years from diagnosis, received radiotherapy. Surveillance of this group should focus on SPNs, in particular, bowel and breast cancers, and cardiac conditions. |
| Databáze: | OpenAIRE |
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