Young cancer patients in Sweden have a 3.04-times higher risk of developing subsequent malignancies compared to their peers, according to a comprehensive 63-year cohort study.
The comprehensive Swedish cohort study (Rebuc) provided insights into the long-term health outcomes of young cancer patients. This population-based study included 65,173 children, adolescents, and young adults (CAYAs) with cancer and 312,935 matched controls, for a total of 378,108 individuals. Data were sourced from multiple Swedish national registers, including the Cancer Register and the National Patient Register, covering the period from 1958 to 2021.
The study, published in The Lancet, reports that CAYAs had a 1.23-times higher risk of cardiovascular disease (95% CI, 1.20-1.26) and a 1.41-times higher risk of external afflictions (95% CI, 1.34-1.49) compared to controls. The highest risk of subsequent malignancies was observed in bone, connective tissue, and soft tissue cancers, with a 36.16-times increased risk.
The study used a retrospective matched cohort design, pairing controls 1:5 based on age, sex, and residence. Data on morbidity, mortality, and demographics were obtained from multiple registers. Statistical analyses included odds ratios (OR) and hazard ratios (HR) to assess the risk of various health outcomes in CAYAs compared to controls.
Findings showed that CAYAs had a significantly higher all-cause mortality rate of 17.9%, compared to 2.6% in the control group. Factors contributing to increased mortality risk included male sex (HR 3.18, 95% CI, 2.74-3.70), non-European birth (HR 2.19, 95% CI, 1.47-3.28), and extensive sick leave (HR 3.07, 95% CI, 2.67-3.53). Conversely, higher education (HR 0.53, 95% CI, 0.43-0.66) and being married (HR 0.41, 95% CI, 0.36-0.48) were associated with reduced mortality risk.
The study also found that CAYAs were at an increased risk for other health conditions. Pulmonary diseases were common, with a 1.62-times higher risk (95% CI, 1.47-1.78). Kidney and genitourinary diseases were present in 47.7% of CAYAs, with a 1.62-times higher risk (95% CI, 1.62-1.68). There was no elevated risk for diabetes among CAYAs.
This study provides data on the long-term health impacts and mortality risks for young cancer patients, highlighting the influence of demographic and socioeconomic factors. Further research may be needed to address these disparities in cancer care and develop tailored interventions.
Full disclosures can be found in the original study.