Long-term adverse outcomes following five-year survival of cancer diagnosed before 40 years age

Fidler, Miranda Marie (2016). Long-term adverse outcomes following five-year survival of cancer diagnosed before 40 years age. University of Birmingham. Ph.D.

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Purpose: Survival from childhood, teenage, and young adult cancer has increased substantially, with approximately 80% now surviving at least five-years. However, curative treatments are often associated with adverse late effects. This thesis investigated the risk of late adverse health and social outcomes following five-year survival of cancer diagnosed before age 40 years using the British Childhood Cancer Survivor Study (BCCSS) and Teenage and Young Adult Cancer Survivor
Study (TY ACSS).
Material and Methods: The BCCSS is a population-based cohort of 34,489 five-year survivors of childhood (<15 years) cancer diagnosed from 1940-2006 in Great Britain. The TY ACSS is a population-based cohort of 200,945 five-year survivors of teenage and young adult (15-39 years) cancer diagnosed from 1971-2006 in England and Wales.
Results: Some survivors were found to have increased risks of premature mortality, subsequent primary neoplasms, hospitalizations, poor quality-of-life, and psychosocial limitations. However, for premature mortality, the number of excess deaths is decreasing among those more recently diagnosed for several causes-of-death.
Conclusions: Survivors of cancer diagnosed before age 40 are at an increased risk of a range of adverse late effects compared to that expected. The findings reported in this thesis will be useful for risk stratification, updating clinical guidelines, and informing survivors and clinicians.

Type of Work: Thesis (Doctorates > Ph.D.)
Award Type: Doctorates > Ph.D.
College/Faculty: Colleges (2008 onwards) > College of Medical & Dental Sciences
School or Department: School of Health and Population Sciences
Funders: None/not applicable
Subjects: R Medicine > RA Public aspects of medicine
R Medicine > RC Internal medicine > RC0254 Neoplasms. Tumors. Oncology (including Cancer)
URI: http://etheses.bham.ac.uk/id/eprint/6638


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