Cancer Survival and Excess Mortality Estimates among Adolescents and Young Adults in Western Australia, 1982-2004: A Population-Based Study

被引：13

作者：

Haggar, Fatima A. ^{[1
,2
]}

Pereira, Gavin ^{[3
,4
]}

Preen, David D. ^{[1
]}

Holman, C. D'Arcy J. ^{[1
]}

Einarsdottir, Kristjana ^{[3
]}

机构：

[1] Univ Western Australia, Ctr Hlth Serv Res, Sch Populat Hlth, Crawley, Australia

[2] Univ Ottawa, Ottawa Hosp Res Inst, Ottawa, ON, Canada

[3] Univ Western Australia, Ctr Child Hlth Res, Telethon Inst Child Hlth Res, Subiaco, WA, Australia

[4] Yale Univ, Sch Publ Hlth, Yale Ctr Perinatal Pediat & Environm Epidemiol, New Haven, CT USA

来源：

PLOS ONE | 2013年 / 8卷 / 02期

关键词：

ACUTE LYMPHOBLASTIC-LEUKEMIA; GERM-CELL TUMORS; CHILDHOOD; END; SEX;

D O I：

10.1371/journal.pone.0055630

中图分类号：

O [数理科学和化学]; P [天文学、地球科学]; Q [生物科学]; N [自然科学总论];

学科分类号：

07 ; 0710 ; 09 ;

摘要：

Background: Data are limited on cancer outcomes in adolescents and young adults. Methods: Based on data from the Western Australian Data Linkage System, this study modelled survival and excess mortality in all adolescents and young adults aged 15-39 years in Western Australia who had a diagnosis of cancer in the period 1982-2004. Relative survival and excess all-cause mortality for all cancers combined and for principal tumour subgroups were estimated, using the Ederer II method and generalised linear Poisson modelling, respectively. Results: A cancer diagnosis in adolescents and young adults conferred substantial survival decrement. However, overall outcomes improved over calendar period (excess mortality hazard ratio [HR], latest versus earliest diagnostic period: 0.52, trend p<0.0001). Case fatality varied according to age group (HR, oldest versus youngest: 1.38, trend p<0.0001), sex (HR, female versus male: 0.66, 95% confidence interval [CI] 0.62-0.71), ethnicity (HR, Aboriginal versus others: 1.47, CI 1.23-1.76), geographical area (HR, rural/remote versus urban: 1.13, CI 1.04-1.23) and residential socioeconomic status (HR, lowest versus highest quartile: 1.14, trend p<0.05). Tumour subgroups differed substantially in frequency according to age group and sex, and were critical outcome determinants. Conclusions: Marked progressive calendar-time improvement in overall outcomes was evident. Further research is required to disentangle the contributions of tumour biology and health service factors to outcome disparities between ethnodemographic, geographic and socioeconomic subgroups of adolescents and young adults with cancer.

引用

页数：8

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