{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,10]],"date-time":"2026-02-10T18:47:12Z","timestamp":1770749232004,"version":"3.50.0"},"reference-count":36,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2020,12,12]],"date-time":"2020-12-12T00:00:00Z","timestamp":1607731200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pediatric Blood &amp; Cancer"],"published-print":{"date-parts":[[2021,5]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>People who receive treatment for cancer during childhood often experience subsequent complications of therapy, known as late effects, which can lead to an increased risk of death.<\/jats:p><\/jats:sec><jats:sec><jats:title>Procedure<\/jats:title><jats:p>Using deidentified population\u2010based data from the Australian Childhood Cancer Registry for children aged 0\u201014 diagnosed with cancer during the period 1983\u20102011 and who survived for a minimum of 5\u00a0years, we examined disease\u2010related deaths (other than cancer recurrence or second primary cancers) that occurred up to 31 December 2016. Risk of death relative to the general population was approximated using standardised mortality ratios (SMRs). Treatment received was stratified according to the intensity of treatment rating, version 3 (ITR\u20103).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>During the study period, 82 noncancer disease\u2010related deaths were recorded among 13\u00a0432 childhood cancer survivors, four times higher than expected (SMR\u00a0=\u00a04.43, 95% CI\u00a0=\u00a03.57\u20105.50). A clear link to treatment intensity was observed, with the relative risk of noncancer disease\u2010related mortality being twice as high for children who underwent \u2018most intensive\u2019 treatment (SMR\u00a0=\u00a05.94, 95% CI\u00a0=\u00a03.69\u20109.55) compared to the \u2018least intensive\u2019 treatment group (SMR\u00a0=\u00a02.98, 95% CI\u00a0=\u00a01.42\u20106.24; <jats:italic>P<\/jats:italic><jats:sub>trend<\/jats:sub>\u00a0=\u00a0.01). Thirty\u2010year cumulative mortality from noncancer disease\u2010related deaths was estimated at 1.4% (95% CI\u00a0=\u00a01.1\u20101.9) after adjusting for competing causes of death such as cancer, accidents, or injuries.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Although childhood cancer survivors are at increased relative risk of death from noncancer diseases, particularly those who undergo more intensive treatment, the cumulative mortality within 30\u00a0years of diagnosis remains small. Knowledge of late effects can guide surveillance of survivors and treatment modification, without wanting to compromise the high rates of survival.<\/jats:p><\/jats:sec>","DOI":"10.1002\/pbc.28835","type":"journal-article","created":{"date-parts":[[2020,12,12]],"date-time":"2020-12-12T11:03:35Z","timestamp":1607771015000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Late mortality from other diseases following childhood cancer in Australia and the impact of intensity of treatment"],"prefix":"10.1002","volume":"68","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2721-9083","authenticated-orcid":false,"given":"Danny R.","family":"Youlden","sequence":"first","affiliation":[{"name":"Cancer Council Queensland  Brisbane Queensland Australia"},{"name":"Menzies Health Institute Queensland Griffith University  Gold Coast Queensland Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Thomas S.","family":"Walwyn","sequence":"additional","affiliation":[{"name":"Perth Children's Hospital  Nedlands Western Australia Australia"},{"name":"Medical School (Division of Paediatrics) University of Western Australia  Perth Western Australia Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Richard J.","family":"Cohn","sequence":"additional","affiliation":[{"name":"Kids Cancer Centre Sydney Children's Hospital  Sydney New South Wales Australia"},{"name":"School of Women's and Children's Health University of New South Wales  Sydney New South Wales Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hazel E.","family":"Harden","sequence":"additional","affiliation":[{"name":"Queensland Cancer Control Safety and Quality Partnership (consumer representative) Cancer Alliance Queensland  Brisbane Queensland Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jason D.","family":"Pole","sequence":"additional","affiliation":[{"name":"Centre for Health Services Research The University of Queensland  Brisbane Queensland Australia"},{"name":"Dalla Lana School of Public Health The University of Toronto  Toronto Ontario Canada"},{"name":"ICES  Toronto Ontario Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joanne F.","family":"Aitken","sequence":"additional","affiliation":[{"name":"Cancer Council Queensland  Brisbane Queensland Australia"},{"name":"Menzies Health Institute Queensland Griffith University  Gold Coast Queensland Australia"},{"name":"Institute for Resilient Regions University of Southern Queensland  Brisbane Queensland Australia"},{"name":"School of Public Health The University of Queensland  Brisbane Queensland Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2020,12,12]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamaoncol.2019.5582"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1007\/978-981-10-1844-2_13"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2008.21.1953"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2013.6296"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.yapd.2017.03.014"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1002\/(SICI)1097-0215(1999)83:12 <25::AID-IJC6>3.0.CO;2-Q"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2017.76.4696"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.31279"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11764-016-0522-y"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1093\/jnci\/djn310"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2008.21.1425"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2010.923"},{"key":"e_1_2_10_14_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2001.19.13.3173"},{"key":"e_1_2_10_15_1","doi-asserted-by":"publisher","DOI":"10.5694\/j.1326-5377.2010.tb03902.x"},{"key":"e_1_2_10_16_1","unstructured":"Cancer Council Queensland.The Australian Childhood Cancer Registry.Cancer Council Queensland;2020.https:\/\/cancerqld.org.au\/research\/viertel-cancer-research-centre\/childhood-cancer\/australian-childhood-cancer-registry\/. 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