Risk of hospitalization for survivors of childhood and adolescent cancer

doi:10.1158/1055-9965.EPI-13-1090

. 2014 Jul;23(7):1280-9.

doi: 10.1158/1055-9965.EPI-13-1090. Epub 2014 Jun 12.

Risk of hospitalization for survivors of childhood and adolescent cancer

Affiliations

¹ Authors' Affiliations: Cancer Control and Population Sciences Research Program; Center for Children's Cancer Research; Department of Pediatrics, University of Utah School of Medicine; anne.kirchhoff@hci.utah.edu.
² Authors' Affiliations: Cancer Control and Population Sciences Research Program; Center for Children's Cancer Research; Department of Pediatrics, University of Utah School of Medicine;
³ Center for Children's Cancer Research; Department of Pediatrics, University of Utah School of Medicine;
⁴ Department of Internal Medicine, Division of Epidemiology;
⁵ Authors' Affiliations: Cancer Control and Population Sciences Research Program; Department of Internal Medicine, Division of Epidemiology;
⁶ Authors' Affiliations: Cancer Control and Population Sciences Research Program;
⁷ Rutgers Cancer Institute of New Jersey, New Brunswick, New Jersey; and.
⁸ Authors' Affiliations: Cancer Control and Population Sciences Research Program; Pedigree and Population Resource (Utah Population Database), Huntsman Cancer Institute; Department of Family and Consumer Studies, University of Utah, Salt Lake City, Utah;
⁹ Pedigree and Population Resource (Utah Population Database), Huntsman Cancer Institute;
¹⁰ Department of Internal Medicine and University of New Mexico Cancer Center, University of New Mexico, Albuquerque, New Mexico.

PMID: 24925676
PMCID: PMC6125154
DOI: 10.1158/1055-9965.EPI-13-1090

Risk of hospitalization for survivors of childhood and adolescent cancer

Anne C Kirchhoff et al. Cancer Epidemiol Biomarkers Prev. 2014 Jul.

. 2014 Jul;23(7):1280-9.

doi: 10.1158/1055-9965.EPI-13-1090. Epub 2014 Jun 12.

Authors

Affiliations

¹ Authors' Affiliations: Cancer Control and Population Sciences Research Program; Center for Children's Cancer Research; Department of Pediatrics, University of Utah School of Medicine; anne.kirchhoff@hci.utah.edu.
² Authors' Affiliations: Cancer Control and Population Sciences Research Program; Center for Children's Cancer Research; Department of Pediatrics, University of Utah School of Medicine;
³ Center for Children's Cancer Research; Department of Pediatrics, University of Utah School of Medicine;
⁴ Department of Internal Medicine, Division of Epidemiology;
⁵ Authors' Affiliations: Cancer Control and Population Sciences Research Program; Department of Internal Medicine, Division of Epidemiology;
⁶ Authors' Affiliations: Cancer Control and Population Sciences Research Program;
⁷ Rutgers Cancer Institute of New Jersey, New Brunswick, New Jersey; and.
⁸ Authors' Affiliations: Cancer Control and Population Sciences Research Program; Pedigree and Population Resource (Utah Population Database), Huntsman Cancer Institute; Department of Family and Consumer Studies, University of Utah, Salt Lake City, Utah;
⁹ Pedigree and Population Resource (Utah Population Database), Huntsman Cancer Institute;
¹⁰ Department of Internal Medicine and University of New Mexico Cancer Center, University of New Mexico, Albuquerque, New Mexico.

PMID: 24925676
PMCID: PMC6125154
DOI: 10.1158/1055-9965.EPI-13-1090

Abstract

Background: Childhood cancer survivors may be at increased risk of hospitalization because of cancer-related late effects.

Methods: Using data from population-based research resources in Utah, we identified childhood and adolescent cancer survivors who were diagnosed from 1973 to 2005 (N = 2,571). We selected a comparison cohort based on birth year and sex (N = 7,713). Hospitalizations from 1996 to 2010, excluding pregnancy and delivery, were determined from discharge records. Multivariable regressions were used to evaluate hospitalization admissions, length of stay, and diagnosis for survivors starting five years from diagnosis versus the comparison cohort.

Results: When follow-up began in 1996, there were N = 1,499 survivors and N = 7,219 comparisons who were alive and eligible for follow-up. Average follow-up for survivors was 13.5 years (SD = 8.5) and for the comparison 14.0 years (SD = 8.7; P = 0.05). Survivors were hospitalized, on average, 1.62 (SD = 3.37) times contrasted to 0.79 (SD = 1.73) for the comparison cohort. In multivariable analyses, the hazard ratio (HR) of any hospitalization since 1996 was higher for survivors than the comparison cohort [HR, 1.52, 95% confidence interval (CI), 1.31-1.66]. Survivors experienced a higher hospital admission rate [rate ratio (RR) = 1.67; 95% CI, 1.58-1.77] than the comparison cohort. The number of hospitalizations was highest for neuroblastoma (RR = 2.21; 95% CI, 1.84-2.66) and bone tumors (RR = 2.55; 95% CI, 2.14-3.02) in reference to the comparison cohort. Survivors were hospitalized because of blood disorders more often (HR, 14.2; 95% CI, 6.3-32.0).

Conclusions: The risk of hospitalization and lengths of stay are elevated among childhood cancer survivors.

Impact: Research to identify strategies to prevent and manage survivors' health problems in outpatient settings is needed.

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Conflict of interest statement

Disclosure of Potential Conflicts of Interest

No potential conflicts of interest were disclosed.

Figures

**Figure 1.**
HRs and 95% CIs of hospital diagnosis for full survivor sample versus comparison cohort (reference). *, significant at P < 0.05.

See this image and copyright information in PMC

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References

1. Oeffinger KC, Mertens AC, Sklar CA, Kawashima T, Hudson MM, Meadows AT, et al. Chronic health conditions in adult survivors of childhood cancer. N Engl J Med 2006;355: 1572–82. - PubMed
1. Nathan PC, Greenberg ML, Ness KK, Hudson MM, Mertens AC, Mahoney MC, et al. Medical care in long-term survivors of childhood cancer: a report from the Childhood Cancer Survivor Study. J Clin Oncol 2008;26:4401–9. - PMC - PubMed
1. Oeffinger KC, Mertens AC, Hudson MM, Gurney JG, Casillas J, Chen H, et al. Health care of young adult survivors of childhood cancer: a report from the Childhood Cancer Survivor Study. Ann Fam Med 2004;2:61–70. - PMC - PubMed
1. Kurt BA, Nolan VG, Ness KK, Neglia JP, Tersak JM, Hudson MM, et al. Hospitalization rates among survivors of childhood cancer in the Childhood Cancer Survivor Study cohort. Pediatr Blood Cancer 2012;59:126–32. - PMC - PubMed
1. Bradley NM, Lorenzi MF, Abanto Z, Sheps S, Broemeling AM, Spinelli JJ, et al. Hospitalisations 1998–2000 in a British Columbia population-based cohort of young cancer survivors: report of the childhood/adolescent/young adult cancer survivors (CAYACS) research program. Eur J Cancer 2010;46:2441–8. - PubMed

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[1] Oeffinger KC, Mertens AC, Sklar CA, Kawashima T, Hudson MM, Meadows AT, et al. Chronic health conditions in adult survivors of childhood cancer. N Engl J Med 2006;355: 1572–82. - PubMed

[2] Oeffinger KC, Mertens AC, Sklar CA, Kawashima T, Hudson MM, Meadows AT, et al. Chronic health conditions in adult survivors of childhood cancer. N Engl J Med 2006;355: 1572–82. - PubMed

[3] Nathan PC, Greenberg ML, Ness KK, Hudson MM, Mertens AC, Mahoney MC, et al. Medical care in long-term survivors of childhood cancer: a report from the Childhood Cancer Survivor Study. J Clin Oncol 2008;26:4401–9. - PMC - PubMed

[4] Nathan PC, Greenberg ML, Ness KK, Hudson MM, Mertens AC, Mahoney MC, et al. Medical care in long-term survivors of childhood cancer: a report from the Childhood Cancer Survivor Study. J Clin Oncol 2008;26:4401–9. - PMC - PubMed

[5] Oeffinger KC, Mertens AC, Hudson MM, Gurney JG, Casillas J, Chen H, et al. Health care of young adult survivors of childhood cancer: a report from the Childhood Cancer Survivor Study. Ann Fam Med 2004;2:61–70. - PMC - PubMed

[6] Oeffinger KC, Mertens AC, Hudson MM, Gurney JG, Casillas J, Chen H, et al. Health care of young adult survivors of childhood cancer: a report from the Childhood Cancer Survivor Study. Ann Fam Med 2004;2:61–70. - PMC - PubMed

[7] Kurt BA, Nolan VG, Ness KK, Neglia JP, Tersak JM, Hudson MM, et al. Hospitalization rates among survivors of childhood cancer in the Childhood Cancer Survivor Study cohort. Pediatr Blood Cancer 2012;59:126–32. - PMC - PubMed

[8] Kurt BA, Nolan VG, Ness KK, Neglia JP, Tersak JM, Hudson MM, et al. Hospitalization rates among survivors of childhood cancer in the Childhood Cancer Survivor Study cohort. Pediatr Blood Cancer 2012;59:126–32. - PMC - PubMed

[9] Bradley NM, Lorenzi MF, Abanto Z, Sheps S, Broemeling AM, Spinelli JJ, et al. Hospitalisations 1998–2000 in a British Columbia population-based cohort of young cancer survivors: report of the childhood/adolescent/young adult cancer survivors (CAYACS) research program. Eur J Cancer 2010;46:2441–8. - PubMed

[10] Bradley NM, Lorenzi MF, Abanto Z, Sheps S, Broemeling AM, Spinelli JJ, et al. Hospitalisations 1998–2000 in a British Columbia population-based cohort of young cancer survivors: report of the childhood/adolescent/young adult cancer survivors (CAYACS) research program. Eur J Cancer 2010;46:2441–8. - PubMed

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Risk of hospitalization for survivors of childhood and adolescent cancer

Affiliations

Risk of hospitalization for survivors of childhood and adolescent cancer

Authors

Affiliations

Abstract

Conflict of interest statement

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