Forskning
Udskriv Udskriv
Switch language
Region Hovedstaden - en del af Københavns Universitetshospital
Udgivet

Endocrine Late Effects in Survivors of Cancer in Adolescence and Young Adulthood: A Danish Population-Based Cohort Study

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

  1. Assessment of Suicidal Behaviors Among Individuals With Autism Spectrum Disorder in Denmark

    Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

  2. Mortality Among Young Adults Born Preterm and Early Term in 4 Nordic Nations

    Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

  3. Assessment of Outcomes Among Patients With Venous Thromboembolism With and Without Chronic Kidney Disease

    Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

  1. Early indicators of primary brain tumours: a population-based study with 10 years’ follow-up

    Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

  2. Gynaecological cancer leads to long-term sick leave and permanently reduced working ability years after diagnosis

    Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

  3. Polygenic risk score-analysis of thromboembolism in patients with acute lymphoblastic leukemia

    Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

Vis graf over relationer

Importance: As survival rates from cancer have improved dramatically over the last decades, there is a need to explore the long-term consequences. Adolescents and young adults with cancer are at risk for several therapy-related late effects; however, these have not been studied extensively.

Objective: To investigate the lifetime risks of endocrine late effects of cancer and cancer treatment in adolescent and young adult cancer survivors.

Design, Setting, and Participants: This Danish, nationwide, population-based cohort study was conducted from January 1, 1976, through December 31, 2009, and included follow-up from January 1, 1977, through December 31, 2010. A total of 32 548 one-year cancer survivors diagnosed at ages 15 to 39 years were identified using the Danish Cancer Registry and 188 728 cancer-free comparison participants matched by year of birth and sex were randomly chosen from the Danish Civil Registration system. Analyses were performed from July 3, 2015, to February 27, 2018.

Exposures: Individuals in the survivor cohort were diagnosed with a first primary cancer at ages 15 to 39 years and received treatment according to recommendations and guidelines at time of diagnosis.

Main Outcomes and Measures: By linkage to the National Patient Register, all hospital contacts for endocrine diseases were identified, and standardized hospitalization rate ratios (RRs) and absolute excess risks (AERs) were calculated.

Results: A total of 32 548 adolescent and young adult 1-year cancer survivors (14 021 [43.1%] male) in the Danish Patient Registry were followed up for 379 157 person-years (median [range]: 10 [0-34] years) and 188 728 cancer-free participants (82 669 [43.8%] male) for comparison were followed up for 2 958 994 person-years (median [range]: 15 [0-34] years). A total of 2129 survivors (6.5%) had at least 1 hospital contact for an endocrine disease, while 1232.0 (3.8%) were expected, yielding a statistically significant increased RR of 1.73 (95% CI, 1.65-1.81). The RRs were highest for testicular hypofunction (75.12; 95% CI, 45.99-122.70), ovarian hypofunction (14.65; 95% CI, 8.29-25.86), and pituitary hypofunction (11.14; 95% CI, 8.09-15.34). The leading reasons for hospital contacts were thyroid disease (38.0% of total AER), testicular dysfunction (17.1% of total AER), and diabetes (14.4% of total AER). Leukemia survivors were at a high risk for any endocrine disease (RR, 3.97; 95% CI, 3.10-5.09), while Hodgkin lymphoma survivors (RR, 3.06; 95% CI, 2.62-3.57) had the highest disease-specific excess risk for hypothyroidism (AER, 362 per 100 000 person-years; 95% CI, 280-443 per 100 000 person-years).

Conclusions and Relevance: The increased risk for endocrine diseases in adolescent and young adult cancer survivors indicates the need for counseling and follow-up, and could guide future preventive measures and surveillance strategies. Additional studies are required to determine exact associations between treatment regimens and endocrine diseases.

OriginalsprogEngelsk
TidsskriftJAMA network open
Vol/bind1
Udgave nummer2
Sider (fra-til)e180349
ISSN2574-3805
DOI
StatusUdgivet - 1 jun. 2018

ID: 56314097