Measuring childhood cancer late effects: evidence of a healthy survivor effect
To access publisher's full text version of this article click on the hyperlink below Given considerable focus on health outcomes among childhood cancer survivors, we aimed to explore whether survivor bias is apparent during long-term follow-up of childhood cancer survivors. METHODS: We identifi...
Published in: | European Journal of Epidemiology |
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Online Access: | http://hdl.handle.net/2336/620456 https://doi.org/10.1007/s10654-017-0305-4 |
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ftlandspitaliuni:oai:www.hirsla.lsh.is:2336/620456 2023-05-15T16:51:49+02:00 Measuring childhood cancer late effects: evidence of a healthy survivor effect Asdahl, Peter Haubjerg Ojha, Rohit Priyadarshi Winther, Jeanette Falck Holmqvist, Anna Sällfors de Fine Licht, Sofie Gudmundsdottir, Thorgerdur Madanat-Harjuoja, Laura Tryggvadottir, Laufey Andersen, Klaus Kaae Hasle, Henrik 1 Aarhus Univ Hosp, Dept Pediat, Aarhus, Denmark 2 Hosp Unit Jutland West, Dept Hematol, Holstebro, Denmark 3 JPS Hlth Network, Ctr Outcomes Res, Ft Worth, TX USA 4 Danish Canc Soc Res Ctr, Copenhagen, Denmark Show more 5 Landspitali Univ Hosp, Childrens Hosp, Reykjavik, Iceland Show more 6 Skane Univ Hosp, Pediat Hematol & Oncol, Lund, Sweden 7 Finnish Canc Registry, Helsinki, Finland Show more 8 Univ Iceland, Fac Med, Reykjavik, Iceland 9 Iceland Canc Registry, Reykjavik, Iceland 2018 http://hdl.handle.net/2336/620456 https://doi.org/10.1007/s10654-017-0305-4 en eng http://link.springer.com/10.1007/s10654-017-0305-4 Measuring childhood cancer late effects: evidence of a healthy survivor effect 2017, 32 (12):1089 European Journal of Epidemiology 0393-2990 1573-7284 doi:10.1007/s10654-017-0305-4 http://hdl.handle.net/2336/620456 European Journal of Epidemiology Archived with thanks to European Journal of Epidemiology National Consortium - Landsaðgangur Krabbamein Krabbameinssjúklingar Heilsufar Algengi sjúkdóma PED12 Cancer Survivors Health Status Article 2018 ftlandspitaliuni https://doi.org/10.1007/s10654-017-0305-4 2022-05-29T08:22:18Z To access publisher's full text version of this article click on the hyperlink below Given considerable focus on health outcomes among childhood cancer survivors, we aimed to explore whether survivor bias is apparent during long-term follow-up of childhood cancer survivors. METHODS: We identified all 1-year survivors of cancer diagnosed before 20 years of age in Denmark, Finland, Iceland, and Sweden. From the general population, we randomly sampled a comparison cohort. Study individuals were followed for hospitalizations for diseases of the gastroenterological tract, endocrine system, cardiovascular system, or urinary tract from the start of the cancer registries to 2010. We estimated cumulative incidence with death as competing risk and used threshold regression to compare the hazards of the diseases of interest at ages 20, 40, 60, and 75 years. RESULTS: Our study included 27,007 one-year survivors of childhood cancer and 165,620 individuals from the general population. The cumulative incidence of all four outcomes was higher for childhood cancer survivors during early adulthood, but for three outcomes, the cumulative incidence was higher for the general population after age 55 years. The hazard ratios (HRs) decreased for all outcomes with increasing age, and for two of the outcomes, the hazards were higher for the general population at older ages (endocrine diseases: age-specific HRs = 3.0, 1.4, 1.0, 0.87; Cardiovascular diseases: age-specific HRs = 4.1, 1.4, 0.97, 0.84). CONCLUSIONS: Our findings provide empirical evidence that survivor bias attenuates measures of association when comparing survivors with the general population. The design and analysis of studies among childhood cancer survivors, particularly as this population attains older ages, should account for survivor bias to avoid misinterpreting estimates of disease burden. Danish Council for Strategic Research Danish Child Cancer Foundation Article in Journal/Newspaper Iceland Hirsla - Landspítali University Hospital research archive European Journal of Epidemiology 32 12 1089 1096 |
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Open Polar |
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Hirsla - Landspítali University Hospital research archive |
op_collection_id |
ftlandspitaliuni |
language |
English |
topic |
Krabbamein Krabbameinssjúklingar Heilsufar Algengi sjúkdóma PED12 Cancer Survivors Health Status |
spellingShingle |
Krabbamein Krabbameinssjúklingar Heilsufar Algengi sjúkdóma PED12 Cancer Survivors Health Status Asdahl, Peter Haubjerg Ojha, Rohit Priyadarshi Winther, Jeanette Falck Holmqvist, Anna Sällfors de Fine Licht, Sofie Gudmundsdottir, Thorgerdur Madanat-Harjuoja, Laura Tryggvadottir, Laufey Andersen, Klaus Kaae Hasle, Henrik Measuring childhood cancer late effects: evidence of a healthy survivor effect |
topic_facet |
Krabbamein Krabbameinssjúklingar Heilsufar Algengi sjúkdóma PED12 Cancer Survivors Health Status |
description |
To access publisher's full text version of this article click on the hyperlink below Given considerable focus on health outcomes among childhood cancer survivors, we aimed to explore whether survivor bias is apparent during long-term follow-up of childhood cancer survivors. METHODS: We identified all 1-year survivors of cancer diagnosed before 20 years of age in Denmark, Finland, Iceland, and Sweden. From the general population, we randomly sampled a comparison cohort. Study individuals were followed for hospitalizations for diseases of the gastroenterological tract, endocrine system, cardiovascular system, or urinary tract from the start of the cancer registries to 2010. We estimated cumulative incidence with death as competing risk and used threshold regression to compare the hazards of the diseases of interest at ages 20, 40, 60, and 75 years. RESULTS: Our study included 27,007 one-year survivors of childhood cancer and 165,620 individuals from the general population. The cumulative incidence of all four outcomes was higher for childhood cancer survivors during early adulthood, but for three outcomes, the cumulative incidence was higher for the general population after age 55 years. The hazard ratios (HRs) decreased for all outcomes with increasing age, and for two of the outcomes, the hazards were higher for the general population at older ages (endocrine diseases: age-specific HRs = 3.0, 1.4, 1.0, 0.87; Cardiovascular diseases: age-specific HRs = 4.1, 1.4, 0.97, 0.84). CONCLUSIONS: Our findings provide empirical evidence that survivor bias attenuates measures of association when comparing survivors with the general population. The design and analysis of studies among childhood cancer survivors, particularly as this population attains older ages, should account for survivor bias to avoid misinterpreting estimates of disease burden. Danish Council for Strategic Research Danish Child Cancer Foundation |
author2 |
1 Aarhus Univ Hosp, Dept Pediat, Aarhus, Denmark 2 Hosp Unit Jutland West, Dept Hematol, Holstebro, Denmark 3 JPS Hlth Network, Ctr Outcomes Res, Ft Worth, TX USA 4 Danish Canc Soc Res Ctr, Copenhagen, Denmark Show more 5 Landspitali Univ Hosp, Childrens Hosp, Reykjavik, Iceland Show more 6 Skane Univ Hosp, Pediat Hematol & Oncol, Lund, Sweden 7 Finnish Canc Registry, Helsinki, Finland Show more 8 Univ Iceland, Fac Med, Reykjavik, Iceland 9 Iceland Canc Registry, Reykjavik, Iceland |
format |
Article in Journal/Newspaper |
author |
Asdahl, Peter Haubjerg Ojha, Rohit Priyadarshi Winther, Jeanette Falck Holmqvist, Anna Sällfors de Fine Licht, Sofie Gudmundsdottir, Thorgerdur Madanat-Harjuoja, Laura Tryggvadottir, Laufey Andersen, Klaus Kaae Hasle, Henrik |
author_facet |
Asdahl, Peter Haubjerg Ojha, Rohit Priyadarshi Winther, Jeanette Falck Holmqvist, Anna Sällfors de Fine Licht, Sofie Gudmundsdottir, Thorgerdur Madanat-Harjuoja, Laura Tryggvadottir, Laufey Andersen, Klaus Kaae Hasle, Henrik |
author_sort |
Asdahl, Peter Haubjerg |
title |
Measuring childhood cancer late effects: evidence of a healthy survivor effect |
title_short |
Measuring childhood cancer late effects: evidence of a healthy survivor effect |
title_full |
Measuring childhood cancer late effects: evidence of a healthy survivor effect |
title_fullStr |
Measuring childhood cancer late effects: evidence of a healthy survivor effect |
title_full_unstemmed |
Measuring childhood cancer late effects: evidence of a healthy survivor effect |
title_sort |
measuring childhood cancer late effects: evidence of a healthy survivor effect |
publishDate |
2018 |
url |
http://hdl.handle.net/2336/620456 https://doi.org/10.1007/s10654-017-0305-4 |
genre |
Iceland |
genre_facet |
Iceland |
op_relation |
http://link.springer.com/10.1007/s10654-017-0305-4 Measuring childhood cancer late effects: evidence of a healthy survivor effect 2017, 32 (12):1089 European Journal of Epidemiology 0393-2990 1573-7284 doi:10.1007/s10654-017-0305-4 http://hdl.handle.net/2336/620456 European Journal of Epidemiology |
op_rights |
Archived with thanks to European Journal of Epidemiology National Consortium - Landsaðgangur |
op_doi |
https://doi.org/10.1007/s10654-017-0305-4 |
container_title |
European Journal of Epidemiology |
container_volume |
32 |
container_issue |
12 |
container_start_page |
1089 |
op_container_end_page |
1096 |
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1766041934922514432 |