Long-Term Mortality Among Five-Year Survivors of Childhood Cancer

Multicenter clinical trials for treating childhood cancer have resulted in remarkable improvement in cure rates. Since over 70% of children diagnosed with cancer will now survive at least 5 years following diagnosis, there is a growing cohort at risk for complications of cancer treatment who are under the care of primary care physicians. Childhood cancer survivors remain at significant risk for death from recurrence of their primary cancer, second malignancies, and dysfunction of nearly every organ system.

The authors from the Emma Children’s Hospital Academic Medical Center, the Netherlands, report the long-term, cause-specific mortality of childhood cancer survivors in a national cohort of 1378 Dutch childhood cancer patients treated between 1966 and 1996 who had survived at least 5 years after diagnosis. Ninety-nine percent of the survivors identified through a national registry had complete follow-up. Cause-specific mortality was compared with the general population, and relative and absolute excess risks of death were calculated. After a median follow-up of 16.1 years, 9% of patients had died. Seventy-four percent of patients died of …