Amy M Berkman1, J A Livingston1, Kelly Merriman2, Michelle Hildebrandt3, Jian Wang4, Seyedeh Dibaj4, Jennifer McQuade5, Nancy You6, Anita Ying7, Carlos Barcenas8, Diane Bodurka9, April DePombo1, Hun Ju Lee10, John de Groot11, Michael Roth1. 1. Department of Pediatrics, The University of Texas MD Anderson Cancer Center, Houston, Texas. 2. Department of Protocol Research, The University of Texas MD Anderson Cancer Center, Houston, Texas. 3. Department of Epidemiology, The University of Texas MD Anderson Cancer Center, Houston, Texas. 4. Department of Biostatistics, The University of Texas MD Anderson Cancer Center, Houston, Texas. 5. Department of Melanoma Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas. 6. Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas. 7. Department of Endocrine Neoplasia and Hormonal Disorders, The University of Texas MD Anderson Cancer Center, Houston, Texas. 8. Department of Breast Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas. 9. Department of Gynecologic Oncology and Reproductive Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas. 10. Department of Lymphoma and Myeloma, The University of Texas MD Anderson Cancer Center, Houston, Texas. 11. Department of Neuro-Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas.
Abstract
BACKGROUND: Although there are a growing number of survivors of adolescent and young adult (AYA) cancer, to the authors' knowledge the long-term overall survival (OS) patterns for AYA cancer survivors are underreported. The objective of the current study was to assess the long-term survival of AYA cancer survivors and identify factors associated with diminished long-term survival. METHODS: The authors used The University of Texas MD Anderson Cancer Center's tumor registry to identify 5-year survivors of cancer diagnosed as AYAs (ages 15-39 years) between the years 1970 and 2005, and who were alive 5 years after diagnosis. Kaplan-Meier curves were used to estimate OS rates over time, and Cox proportional hazards models were fitted to evaluate the association of covariates with OS. RESULTS: The authors identified 16,728 individuals who were 5-year survivors of cancer and were diagnosed as AYAs with a median follow-up of 20.0 years. The 10-year, 20-year, and 25-year OS rates were 86% (95% confidence interval [95% CI], 85%-86%), 74% (95% CI, 73%-75%), and 68% (95% CI, 67%-68%), respectively, all of which were lower than the age-adjusted estimated survival rates of the general population. Long-term OS improved for AYAs diagnosed between 2000 and 2005 compared with those diagnosed in the prior decades (P < .001). Older age at the time of diagnosis, receipt of radiation, and diagnoses including central nervous system tumors and breast cancer each were associated with diminished long-term survival. CONCLUSIONS: AYA cancer survivors have inferior long-term survival compared with the general population. Studies investigating the prevalence and types of late treatment effects and causes of death among AYA survivors are needed to more accurately identify AYAs who are at highest risk of early or late mortality.
BACKGROUND: Although there are a growing number of survivors of adolescent and young adult (AYA) cancer, to the authors' knowledge the long-term overall survival (OS) patterns for AYA cancer survivors are underreported. The objective of the current study was to assess the long-term survival of AYA cancer survivors and identify factors associated with diminished long-term survival. METHODS: The authors used The University of Texas MD Anderson Cancer Center's tumor registry to identify 5-year survivors of cancer diagnosed as AYAs (ages 15-39 years) between the years 1970 and 2005, and who were alive 5 years after diagnosis. Kaplan-Meier curves were used to estimate OS rates over time, and Cox proportional hazards models were fitted to evaluate the association of covariates with OS. RESULTS: The authors identified 16,728 individuals who were 5-year survivors of cancer and were diagnosed as AYAs with a median follow-up of 20.0 years. The 10-year, 20-year, and 25-year OS rates were 86% (95% confidence interval [95% CI], 85%-86%), 74% (95% CI, 73%-75%), and 68% (95% CI, 67%-68%), respectively, all of which were lower than the age-adjusted estimated survival rates of the general population. Long-term OS improved for AYAs diagnosed between 2000 and 2005 compared with those diagnosed in the prior decades (P < .001). Older age at the time of diagnosis, receipt of radiation, and diagnoses including central nervous system tumors and breast cancer each were associated with diminished long-term survival. CONCLUSIONS: AYA cancer survivors have inferior long-term survival compared with the general population. Studies investigating the prevalence and types of late treatment effects and causes of death among AYA survivors are needed to more accurately identify AYAs who are at highest risk of early or late mortality.
Authors: Amy C MacArthur; John J Spinelli; Paul C Rogers; Karen J Goddard; Zenaida U Abanto; Mary L McBride Journal: Pediatr Blood Cancer Date: 2007-04 Impact factor: 3.167
Authors: Frederika A van Nimwegen; Michael Schaapveld; Cécile P M Janus; Augustinus D G Krol; Eefke J Petersen; John M M Raemaekers; Wouter E M Kok; Berthe M P Aleman; Flora E van Leeuwen Journal: JAMA Intern Med Date: 2015-06 Impact factor: 21.873
Authors: M C Cardous-Ubbink; R C Heinen; N E Langeveld; P J M Bakker; P A Voûte; H N Caron; F E van Leeuwen Journal: Pediatr Blood Cancer Date: 2004-06 Impact factor: 3.167
Authors: Matthias Schindler; Ben D Spycher; Roland A Ammann; Marc Ansari; Gisela Michel; Claudia E Kuehni Journal: Int J Cancer Date: 2016-03-30 Impact factor: 7.396
Authors: Miranda M Fidler; Raoul C Reulen; Chloe J Bright; Katherine E Henson; Julie S Kelly; Meriel Jenney; Antony Ng; Jeremy Whelan; David L Winter; Clare Frobisher; Michael M Hawkins Journal: Thorax Date: 2018-05-10 Impact factor: 9.139
Authors: Amy M Berkman; Clark R Andersen; Vidya Puthenpura; J A Livingston; Sairah Ahmed; Branko Cuglievan; Michelle A T Hildebrandt; Michael E Roth Journal: Cancer Epidemiol Date: 2021-09-28 Impact factor: 2.984
Authors: Miek C Jong; Eric Mulder; Agnete E Kristoffersen; Trine Stub; Heléne Dahlqvist; Eija Viitasara; E Anne Lown; Winnie Schats; Mats Jong Journal: BMJ Open Date: 2022-05-09 Impact factor: 3.006
Authors: Amy M Berkman; Clark R Andersen; Branko Cuglievan; David C McCall; Philip J Lupo; Susan K Parsons; Courtney D DiNardo; Nicholas J Short; Nitin Jain; Tapan M Kadia; J A Livingston; Michael E Roth Journal: Cancer Epidemiol Biomarkers Prev Date: 2022-06-01 Impact factor: 4.090
Authors: Michael Rost; Vittoria Espeli; Marc Ansari; Nicolas von der Weid; Bernice S Elger; Eva De Clercq Journal: Health Policy Technol Date: 2022-03-04 Impact factor: 5.211
Authors: Amy M Berkman; Clark R Andersen; Vidya Puthenpura; J Andrew Livingston; Sairah Ahmed; Branko Cuglievan; Michelle A T Hildebrandt; Michael E Roth Journal: Cancer Epidemiol Biomarkers Prev Date: 2021-07-08 Impact factor: 4.254