Lancet oncol:早期青少年及青年癌症幸存者的长期预后

2020-02-17 不详 MedSci原创

在青春期和成年早期被诊断出癌症的幸存者的治疗预后未从在儿童时期被诊断出癌症的幸存者的特征中独立分离出来。本研究拟对早期青少年和青年癌症幸存者的长期健康和全因及特殊原因的死亡率进行评估。儿童癌症调查研究(CCSS)是一个回顾性的队列研究,对1970年至1999年期间美国和加拿大27个学术机构中21岁以前诊断为癌症的5年幸存者进行纵向随访。评估了早期青少年和青年癌症幸存者(15-20岁时确诊)和15岁

在青春期和成年早期被诊断出癌症的幸存者的治疗预后未从在儿童时期被诊断出癌症的幸存者的特征中独立分离出来。本研究拟对早期青少年和青年癌症幸存者的长期健康和全因及特殊原因的死亡率进行评估。

儿童癌症调查研究(CCSS)是一个回顾性的队列研究,对1970年至1999年期间美国和加拿大27个学术机构中21岁以前诊断为癌症的5年幸存者进行纵向随访。评估了早期青少年和青年癌症幸存者(15-20岁时确诊)和15岁以下时确诊幸存者的预后。死亡率由国家死亡指数确定。根据美国特定年龄、性别和年份的比率来估计标准死亡率(SMRs)。

在5804位早期青少年和青年幸存者(中位42岁)和5804位儿童癌症幸存者(中位34岁)中,相比普通人群的全因死亡率的SMR分别为5.9(95% CI 5.5-6.2)和6.2(5.8-6.6)。早期青少年和青年幸存者因健康相关原因死亡的SMR低于儿童癌症幸存者(SMR:4.8 vs 6.8),癌症确诊20多年后尤为明显。与同年龄的兄弟姐妹相比,早期青少年和青年癌症幸存者以及儿童癌症幸存者发生严重残疾、危及生命或致命(3-5级)健康状况的风险均增高,发生3-5级心血管、内分泌和肌肉骨骼疾病的风险也增加,虽然早期青少年和青年癌症幸存者的这些风险的增加稍低于儿童癌症幸存者。

早期青少年和青年癌症幸存者比一般人群有更高的死亡风险和严重的、威胁生命的慢性健康状况。但与儿童癌症幸存者相比,早期青少年和青年癌症幸存者具有较低的非复发性、健康相关的SMR和发展为3-5级慢性健康状况的相对风险,其中大部分在癌症发生20多年后最为显著。本研究结果突出了对儿童和早期青少年及青年癌症幸存者进行长期筛查的必要性。

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    2020-12-25 minlingfeng
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    2020-07-09 howi
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    2020-02-17 anti-cancer

    谢谢梅斯分享这么多精彩信息

    0

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