Cumulative burden of 144 conditions, critical care hospitalisation and premature mortality across 26 adult cancers

• Published in: Nature communications Vol. 14; no. 1; p. 1484
• Main Authors: Chang, Wai Hoong, Neal, Richard D., Forster, Martin D., Lai, Alvina G.
• Format: Journal Article
• Language: English
• Published: London Nature Publishing Group UK 17.03.2023; Nature Publishing Group; Nature Portfolio
• Subjects: 692/4028/67; 692/699; 692/700; Adult; Cancer; Cancer Survivors; Chemotherapy; Critical care; Hematology; Hodgkin Disease; Hodgkin's lymphoma; Hospitalization; Humanities and Social Sciences; Humans; Immunology; Lymphoma; Male; Middle Aged; Morbidity; Mortality, Premature; multidisciplinary; Nervous system; Patients; Premature mortality; Radiation therapy; Risk Factors; Science; Science (multidisciplinary); Spinal cord; Survival
• ISSN: 2041-1723; 2041-1723
• DOI: 10.1038/s41467-023-37231-3

A comprehensive evaluation of the total burden of morbidity endured by cancer survivors remains unavailable. This study quantified the burden of 144 health conditions and critical care admissions across 26 adult cancers and treatment modalities in 243,767 adults. By age 60, top conditions ranked by fold difference (cumulative burden in survivors divided by cumulative burden in controls) were haematology, immunology/infection and pulmonary conditions. Patients who had all three forms of treatment (chemotherapy, radiotherapy and surgery) experienced a high cumulative burden of late morbidities compared with patients who received radiotherapy alone. The top five cancers with the highest cumulative burden of critical care admissions by age 60 were bone (12.4 events per 100 individuals [CI: 11.6-13.1]), brain (9.0 [7.5-10.5]), spinal cord and nervous system (7.2 [6.7-7.8]), testis (6.7 [4.9-8.4]) and Hodgkin lymphoma (4.4 [3.6-5.1]). Conditions that were associated with high excess years-of-life-lost were haematological conditions (9.6 years), pulmonary conditions (8.6 years) and immunological conditions or infections (7.8 years). As the population of cancer survivors continues to grow, our results indicate that it is important to tackle long-term health consequences through enacting data-driven policies. Here the authors evaluate the burden of 144 health conditions in adult cancer survivors, and show that the magnitude of late morbidities experienced by survivors varies according to the type of cancer and treatment, highlighting opportunities for optimising patient care