がん生存者は生涯を通じて疾病リスクが高い(Cancer survivors are at increased risk of disease throughout life)

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2024-06-18 リンショーピング大学

スウェーデンは1958年以来、全てのがん患者を国立がん登録に登録してきました。これを利用して、研究者たちは子供、青年、大人としてがんを経験したすべてのがん生存者の後の生活を調査しました。63年分のデータから、25歳未満でがんを経験した約65,000人と、年齢、性別、住居状況が一致する313,000人の対照群を比較しました。その結果、がん生存者は将来がんを再発するリスクが約3倍、心血管疾患のリスクが1.23倍、事故や中毒、自殺のリスクが1.41倍高いことが判明しました。現在の医療システムでは、治療終了後5年間のフォローアップが一般的ですが、この研究はそれが不十分であることを示しています。また、教育レベルが低い、外国人背景がある、未婚の人々は病気や死亡のリスクが高いことも分かりました。研究者たちは次のステップとして、具体的な質問に答えるためにデータをさらに詳細に分析する予定です。

<関連情報>

小児、青年、若年成人のがん患者における60年間の罹患率と死亡率:スウェーデンの集団ベースコホート研究(Rebuc研究) Morbidity and mortality among children, adolescents, and young adults with cancer over six decades: a Swedish population-based cohort study (the Rebuc study)

Margaretha Stenmarker,Panagiotis Mallios,Elham Hedayati,Kenny A. Rodriguez-Wallberg,Aina Johnsson,Joakim Alfredsson,et al.
The Lancet Regional Health – Europe  Published:May 15, 2024
DOI:https://doi.org/10.1016/j.lanepe.2024.100925

がん生存者は生涯を通じて疾病リスクが高い(Cancer survivors are at increased risk of disease throughout life)

Summary

Background
Despite progress in managing cancer in children, adolescents, and young adults (CAYAs), persistent complications may impact their quality of life. This study covers the morbidity and mortality, among CAYAs, with the aim to investigate the influence of socioeconomic factors on outcomes.

Methods
This retrospective matched cohort study included the entire Swedish population of individuals under 25 with cancer 1958–2021. The population was identified from the Cancer Register, and controls were paired 1:5 based on age, sex, and residence. Multiple registers provided data on morbidity, mortality, and demographics.

Findings
This survey covering 63 years, identified 65,173 CAYAs and matched controls, a total of 378,108 individuals (74% females). CAYAs exhibited a 3.04-times higher risk for subsequent cancer (Odds ratio (OR) 95% confidence interval (CI) 2.92–3.17, p < 0.0001), a 1.23-times higher risk for cardiovascular disease (OR 95% CI 1.20–1.26, p < 0.0001), and a 1.41-times higher risk for external affliction (OR 95% CI 1.34–1.49, p < 0.0001). CAYAs had a higher mortality hazard, and after adjusting for socioeconomic factors, males, individuals born outside Europe, and those with greater sick-leave had a higher association with mortality, while education and marriage showed a beneficial association.

Interpretation
The Rebuc study, showed an increased risk for serious complications among young cancer patients in Sweden. Patient-specific variables, demographics, and socioeconomic factors influenced mortality. These results underscore the impact of cancer on the health and lifespan of young individuals and the necessity for further research to address socioeconomic disparities in cancer care.

Funding
Grants from the Medical Research Council of Southeast Sweden (FORSS), ALF Grants, Region Ostergotland, and The Swedish Childhood Cancer Fund.

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