Gastrointestinal and liver disease in Adult Life After Childhood Cancer in Scandinavia : A population-based cohort study
Survival after childhood cancer diagnosis has remarkably improved, but emerging evidence suggests that cancer-directed therapy may have adverse gastrointestinal late effects. We aimed to comprehensively assess the frequency of gastrointestinal and liver late effects among childhood cancer survivors...
Published in: | International Journal of Cancer |
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Format: | Article in Journal/Newspaper |
Language: | English |
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John Wiley & Sons Inc.
2016
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Online Access: | https://lup.lub.lu.se/record/ccb75026-c5f6-4a62-baeb-b18cda6e022d https://doi.org/10.1002/ijc.30198 |
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ftulundlup:oai:lup.lub.lu.se:ccb75026-c5f6-4a62-baeb-b18cda6e022d 2023-05-15T16:51:38+02:00 Gastrointestinal and liver disease in Adult Life After Childhood Cancer in Scandinavia : A population-based cohort study Asdahl, Peter Haubjerg Winther, Jeanette Falck Bonnesen, Trine Gade De Fine Licht, Sofie Gudmundsdottir, Thorgerdur Holmqvist, Anna Sällfors Malila, Nea Tryggvadottir, Laufey Wesenberg, Finn Dahlerup, Jens Frederik Olsen, Jørgen Helge Hasle, Henrik 2016-10-01 https://lup.lub.lu.se/record/ccb75026-c5f6-4a62-baeb-b18cda6e022d https://doi.org/10.1002/ijc.30198 eng eng John Wiley & Sons Inc. https://lup.lub.lu.se/record/ccb75026-c5f6-4a62-baeb-b18cda6e022d http://dx.doi.org/10.1002/ijc.30198 pmid:27194488 wos:000379977200007 scopus:84978204253 International Journal of Cancer; 139(7), pp 1501-1511 (2016) ISSN: 0020-7136 Cancer and Oncology Cancer epidemiology Childhood cancer Gastrointestinal disease Late effects Survivorship contributiontojournal/article info:eu-repo/semantics/article text 2016 ftulundlup https://doi.org/10.1002/ijc.30198 2023-02-01T23:35:13Z Survival after childhood cancer diagnosis has remarkably improved, but emerging evidence suggests that cancer-directed therapy may have adverse gastrointestinal late effects. We aimed to comprehensively assess the frequency of gastrointestinal and liver late effects among childhood cancer survivors and compare this frequency with the general population. Our population-based cohort study included all 1-year survivors of childhood and adolescent cancer in Denmark, Finland, Iceland, Norway and Sweden diagnosed from the 1940s and 1950s. Our outcomes of interest were hospitalization rates for gastrointestinal and liver diseases, which were ascertained from national patient registries. We calculated standardized hospitalization rate ratios (RRs) and absolute excess rates comparing hospitalizations of any gastrointestinal or liver disease and for specific disease entities between survivors and the general population. The study included 31,132 survivors and 207,041 comparison subjects. The median follow-up in the hospital registries were 10 years (range: 0-42) with 23% of the survivors being followed at least to the age of 40 years. Overall, survivors had a 60% relative excess of gastrointestinal or liver diseases [RR: 1.6, 95% confidence interval (CI): 1.6-1.7], which corresponds to an absolute excess of 360 (95% CI: 330-390) hospitalizations per 100,000 person-years. Survivors of hepatic tumors, neuroblastoma and leukemia had the highest excess of gastrointestinal and liver diseases. In addition, we observed a relative excess of several specific diseases such as esophageal stricture (RR: 13; 95% CI: 9.2-20) and liver cirrhosis (RR: 2.9; 95% CI: 2.0-4.1). Our findings provide useful information about the breadth and magnitude of late complications among childhood cancer survivors and can be used for generating hypotheses about potential exposures related to these gastrointestinal and liver late effects. Article in Journal/Newspaper Iceland Lund University Publications (LUP) Norway International Journal of Cancer 139 7 1501 1511 |
institution |
Open Polar |
collection |
Lund University Publications (LUP) |
op_collection_id |
ftulundlup |
language |
English |
topic |
Cancer and Oncology Cancer epidemiology Childhood cancer Gastrointestinal disease Late effects Survivorship |
spellingShingle |
Cancer and Oncology Cancer epidemiology Childhood cancer Gastrointestinal disease Late effects Survivorship Asdahl, Peter Haubjerg Winther, Jeanette Falck Bonnesen, Trine Gade De Fine Licht, Sofie Gudmundsdottir, Thorgerdur Holmqvist, Anna Sällfors Malila, Nea Tryggvadottir, Laufey Wesenberg, Finn Dahlerup, Jens Frederik Olsen, Jørgen Helge Hasle, Henrik Gastrointestinal and liver disease in Adult Life After Childhood Cancer in Scandinavia : A population-based cohort study |
topic_facet |
Cancer and Oncology Cancer epidemiology Childhood cancer Gastrointestinal disease Late effects Survivorship |
description |
Survival after childhood cancer diagnosis has remarkably improved, but emerging evidence suggests that cancer-directed therapy may have adverse gastrointestinal late effects. We aimed to comprehensively assess the frequency of gastrointestinal and liver late effects among childhood cancer survivors and compare this frequency with the general population. Our population-based cohort study included all 1-year survivors of childhood and adolescent cancer in Denmark, Finland, Iceland, Norway and Sweden diagnosed from the 1940s and 1950s. Our outcomes of interest were hospitalization rates for gastrointestinal and liver diseases, which were ascertained from national patient registries. We calculated standardized hospitalization rate ratios (RRs) and absolute excess rates comparing hospitalizations of any gastrointestinal or liver disease and for specific disease entities between survivors and the general population. The study included 31,132 survivors and 207,041 comparison subjects. The median follow-up in the hospital registries were 10 years (range: 0-42) with 23% of the survivors being followed at least to the age of 40 years. Overall, survivors had a 60% relative excess of gastrointestinal or liver diseases [RR: 1.6, 95% confidence interval (CI): 1.6-1.7], which corresponds to an absolute excess of 360 (95% CI: 330-390) hospitalizations per 100,000 person-years. Survivors of hepatic tumors, neuroblastoma and leukemia had the highest excess of gastrointestinal and liver diseases. In addition, we observed a relative excess of several specific diseases such as esophageal stricture (RR: 13; 95% CI: 9.2-20) and liver cirrhosis (RR: 2.9; 95% CI: 2.0-4.1). Our findings provide useful information about the breadth and magnitude of late complications among childhood cancer survivors and can be used for generating hypotheses about potential exposures related to these gastrointestinal and liver late effects. |
format |
Article in Journal/Newspaper |
author |
Asdahl, Peter Haubjerg Winther, Jeanette Falck Bonnesen, Trine Gade De Fine Licht, Sofie Gudmundsdottir, Thorgerdur Holmqvist, Anna Sällfors Malila, Nea Tryggvadottir, Laufey Wesenberg, Finn Dahlerup, Jens Frederik Olsen, Jørgen Helge Hasle, Henrik |
author_facet |
Asdahl, Peter Haubjerg Winther, Jeanette Falck Bonnesen, Trine Gade De Fine Licht, Sofie Gudmundsdottir, Thorgerdur Holmqvist, Anna Sällfors Malila, Nea Tryggvadottir, Laufey Wesenberg, Finn Dahlerup, Jens Frederik Olsen, Jørgen Helge Hasle, Henrik |
author_sort |
Asdahl, Peter Haubjerg |
title |
Gastrointestinal and liver disease in Adult Life After Childhood Cancer in Scandinavia : A population-based cohort study |
title_short |
Gastrointestinal and liver disease in Adult Life After Childhood Cancer in Scandinavia : A population-based cohort study |
title_full |
Gastrointestinal and liver disease in Adult Life After Childhood Cancer in Scandinavia : A population-based cohort study |
title_fullStr |
Gastrointestinal and liver disease in Adult Life After Childhood Cancer in Scandinavia : A population-based cohort study |
title_full_unstemmed |
Gastrointestinal and liver disease in Adult Life After Childhood Cancer in Scandinavia : A population-based cohort study |
title_sort |
gastrointestinal and liver disease in adult life after childhood cancer in scandinavia : a population-based cohort study |
publisher |
John Wiley & Sons Inc. |
publishDate |
2016 |
url |
https://lup.lub.lu.se/record/ccb75026-c5f6-4a62-baeb-b18cda6e022d https://doi.org/10.1002/ijc.30198 |
geographic |
Norway |
geographic_facet |
Norway |
genre |
Iceland |
genre_facet |
Iceland |
op_source |
International Journal of Cancer; 139(7), pp 1501-1511 (2016) ISSN: 0020-7136 |
op_relation |
https://lup.lub.lu.se/record/ccb75026-c5f6-4a62-baeb-b18cda6e022d http://dx.doi.org/10.1002/ijc.30198 pmid:27194488 wos:000379977200007 scopus:84978204253 |
op_doi |
https://doi.org/10.1002/ijc.30198 |
container_title |
International Journal of Cancer |
container_volume |
139 |
container_issue |
7 |
container_start_page |
1501 |
op_container_end_page |
1511 |
_version_ |
1766041763476144128 |