Cancer in childhood, adolescence, and young adults: a population-based study of changes in risk of cancer death during four decades in Norway
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Cancer is one of the most common causes of death among young individuals. The purpose of this study was to explore the risk of early death (the first five years after diagnosis) among children (0–14 years), adolescents (15–19 years), and young adults (20–24 years) with cancer in Norway, born during 1965–1985.
The overall and cancer-specific early deaths were explored by linking population-based national registers (including the Cancer Registry of Norway and the Cause of Death Registry) that include the entire population of Norway (approximately 1.3 million individuals). Hazard and sub-hazard ratios were estimated using Cox regression analyses and competing risk models.
A total of 5,828 individuals were diagnosed with cancer (56.3 % males). During follow-up, 1,415 individuals died from cancer (60.2 % males) within five years after diagnosis. The hazard ratio (HR) of overall death of the cancer patients relative to the general population decreased from 1965 (from HR, 385.8 (95 % confidence interval (CI): 335.3, 443.4) in 1965-74 to HR, 19.7 (CI: 9.3, 41.5) in 2005-09). Over all, there were fewer cancer-related deaths among female compared with male patients (sub-hazard ratio (SHR), 0.83 (CI: 0.74, 0.92)). Except for all hematopoietic malignancies, adolescents and young adult patients had lower risk of cancer death than children.
The difference in risk of cancer and overall deaths between the cancer patients and the general population has been substantially reduced since 1965.
KeywordsChildhood cancer Adolescents and young adults Early cancer death Norway
Acute lymphatic leukemia
Acute myelogenic leukemia
95 % confidence interval
Central nervous system
Cancer Registry of Norway
International Classification of Diseases-7
This work was supported by the Norwegian Cancer Society.
Conflict of interest
The authors declare no conflict of interest.
- 11.NORDCAN (2009) Association of the Nordic Cancer RegistriesGoogle Scholar
- 12.SEER (2011) National cancer instituteGoogle Scholar
- 13.Cancer in Norway (2008) (2009) Cancer incidence, mortality, survival and prevalence in Norway. Kreftregisteret, OsloGoogle Scholar
- 14.World Health Organization (WHO). (2011) ICD systemsGoogle Scholar
- 16.Health Statistics (2002) Atlas on mortality in the European Union: data 1994–1996. Office for Official Publications of the European Communities, LuxembourgGoogle Scholar
- 24.Kaatsch P (2010) Epidemiology of childhood cancer. Cancer Treat Rev 36(4):277–285Google Scholar
- 32.Garwicz S, Moller T, Olsen JH, Sankila R (2004) Nordic studies on late effects of treatment of cancer in childhood and adolescence. Acta Oncol 43(7):682–683Google Scholar
- 36.Kahalley LS, Robinson LA, Tyc VL et al (2012) Risk factors for smoking among adolescent survivors of childhood cancer: A report from the childhood cancer survivor study. Pediatr Blood Cancer 58(3):428–434Google Scholar