Younger cancer survivors 11 times more likely to die prematurely years later: Study
'As people were going further from their diagnosis, they were more likely to die from something else,' epidemiologist says
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Younger cancer survivors, even after successful treatment, are 11.4 times more likely to die an early death than those in the general population, a massive University of Calgary study has found.
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The research that spans from 1983 to 2017 tracked 24,459 adolescent and young adult (AYA) cancer survivors in Alberta, and determined their likelihood of dying prematurely was vastly greater than those in other demographic groups aged 15 to 39 years.
“Among the 24,459 individuals included in the cohort, 5,916 deaths were observed, which was 11.4 times that expected for the general population, equating to 191.6 (deaths per 10,000 person years) excess deaths,” states the study published earlier this month in the medical journal The Lancet.
“To our knowledge, this is the largest, most comprehensive investigation of overall and late mortality among AYA cancer survivors to date.”
By culling decades of statistics from the province’s health-care data, Dr. Miranda Fidler-Benaoudia was able to determine how younger cancer survivors fared 30 years after their initial diagnoses — and it wasn’t encouraging.
“As people were going further from their diagnosis, they were more likely to die from something else, whether it was cardiovascular or respiratory disease or another cancer,” said the epidemiologist at the U of C’s Cumming School of Medicine.
“Radiation (treatment) can cause another cancer to occur . . . these cancers really persist for decades.”
Factors cited in increasing mortality in later years included lower neighbourhood income, a later age of diagnosis, initial treatment plan and the type of original cancer.
Zeroing in youth cancer is something that’s been generally overlooked, with more of the focus on conditions that are more common with older people, said Fidler-Benaoudia.
That reality could also lead to some of the higher mortality rates her research found, she said.
“(Younger cancers) still aren’t really common — younger people may think they’re invincible and this leads to delays in them being diagnosed and it’s something that’s not at the forefront of doctors’ lives,” said Fidler-Benaoudia.
But raising awareness of the long-term effects on that cancer demographic is becoming increasingly urgent, she said, given the rise in disease rates among the younger population.
Among those frequent cancers are colorectal, kidney and breast cancer, though why that is hasn’t been fully determined, said the epidemiologist.
Some of the reasons could be an increase in obesity and a reduction in physical activity, she said.
There’s also no reason to believe the study’s results wouldn’t be replicated in other jurisdictions with similar economies and health-care systems, said Fidler-Benaoudia.
But there is reason for hope, said the researcher, who pointed to the study’s focus on preventive measures for survivors of testicular and endometrial cancers, and Hodgkin lymphoma.
Those could include better screening and lifestyle changes, such as quitting smoking, reducing alcohol consumption and improving diet, said the paper.
“I didn’t want just a bad news story, but one of ‘how can we prevent chronic diseases from occurring?” she said, adding she hopes the findings will be picked up by health-care authorities.
In recent years, treatment has progressed and those mortality rates have improved, but that demographic “is still experiencing more deaths from these cancers,” said Fidler-Benaoudia.
And she says Calgary’s newly opened Arthur J.E. Child Comprehensive Cancer Centre holds greater promise in improving outcomes for younger patients.
Some of that revolves around addressing patients’ mental-health needs, she said.
“For the first time, we have a space for young adults to go to, where they’re not so lonely,” said Fidler-Benaoudia.
X: @BillKaufmannjrn
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