Noncancer-related mortality risks in adult survivors of pediatric malignancies: the childhood cancer survivor study

Purpose

We sought to identify factors, other than cancer-related treatment and presence/severity of chronic health conditions, which may be associated with late mortality risk among adult survivors of pediatric malignancies.

Methods

Using the Childhood Cancer Survivor Study cohort and a case–control design, 445 participants who died from causes other than cancer recurrence/progression or non-health-related events were compared with 7,162 surviving participants matched for primary diagnosis, age at baseline questionnaire, time from diagnosis to baseline questionnaire, and time at-risk. Odds ratios (ORs) and 95 % confidence intervals (CIs) were calculated for overall/cause-specific mortality. Independent measures included number/severity of chronic conditions, medical care, health-related behaviors, and health perceptions/concerns.

Results

Adjusting for education, income, chemotherapy/radiation exposures, and number/severity of chronic health conditions, an increased risk for all-cause mortality was associated with exercising fewer than 3 days/week (OR?=?1.72, CI 1.27–2.34), being underweight (OR?=?2.58, CI 1.55–4.28), increased medical care utilization (P?P?Conclusions Factors independent of cancer treatment and chronic health conditions modify the risk of death among adult survivors of pediatric cancer.

Implications for Cancer Survivors

Continued cohort observation may inform interventions to reduce mortality.