Late morbidity leading to hospitalization among 5-year survivors of young adult cancer: A report of the childhood, adolescent, and young adult cancer survivors (CAYACS) research program

abstract

To estimate the risk of late morbidity leading to hospitalization among young adult cancer 5-yr survivors compared to the general population and to examine the long-term effects of demographic and disease-related factors on late morbidity, a retrospective cohort of 902 5-yr survivors of young adult cancer diagnosed between 1981 and 1999 was identified from British Columbia (BC) Cancer Registry. A matched comparison group (N=9020) was randomly selected from the provincial health insurance plan. All hospitalizations until the end of 2006 were determined from the BC health insurance plan hospitalization records. The Poisson regression model was used to estimate the rate ratios for late morbidity leading to hospitalization after adjusting for socio-demographic and clinical risk factors. Overall, 455(50.4%) survivors and 3419 (37.9%) individuals in the comparison group had at least one type of late morbidity leading to hospitalization. The adjusted risk of this morbidity for survivors was 1.4 times higher than for the comparison group (95% CI, 1.22-1.54). The highest risks were found for hospitalization due to blood disease (RR, 4.2; 95%CI, 1.98-8.78) and neoplasm (RR, 4.3; 95%CI, 3.41-5.33) except pregnancy. Survivors with three treatment modalities had three folds higher risk of having any type of late morbidity (RR, 3.22; 95%CI,2.09-4.94) than the comparison. These findings emphasize that young adult cancer survivors still have high risks of a wide range of late morbidities.