{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,8]],"date-time":"2026-07-08T05:26:52Z","timestamp":1783488412121,"version":"3.55.0"},"reference-count":37,"publisher":"MDPI AG","issue":"16","license":[{"start":{"date-parts":[[2021,8,5]],"date-time":"2021-08-05T00:00:00Z","timestamp":1628121600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100006058","name":"St. Baldrick's Foundation","doi-asserted-by":"publisher","award":["Scholar"],"award-info":[{"award-number":["Scholar"]}],"id":[{"id":"10.13039\/100006058","id-type":"DOI","asserted-by":"publisher"}]},{"name":"The Saban Research Institute of Children's Hospital Los Angeles","award":["Research Career Development Award"],"award-info":[{"award-number":["Research Career Development Award"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cancers"],"abstract":"<jats:p>Despite an aggregate 5-year survival of 85%, many adolescents and young adults (AYAs, 15\u201339 years old) treated for cancer die prematurely decades later. To develop a more complete understanding of this problem, particularly the role of specific subsequent malignant neoplasms (SMNs), we used the SEER-9 registry to analyze causes of death (COD: Primary cancer, SMN, non-malignant conditions) among 162,317 AYAs diagnosed with first cancer between 1975\u20132012 and surviving 5 or more years. Cumulative mortality, attributable mortality, standardized mortality ratios (SMRs), and adjusted hazard ratios were determined for each cancer site and COD. At 30 years, cumulative mortality due to primary cancer was matched by that due to all other causes (12.8% 95% CI [12.5%, 13.0%] for primary cancer versus 12.8% [12.5%, 13.1%] for all other causes combined) in the combined cohort, and was overtaken by non-malignant conditions in Hodgkin lymphoma, testicular, cervical\/uterine, and thyroid cancers. Overall, SMNs accounted for 20% of malignant deaths, the most common being lung\/bronchus (25.6%), colorectal\/liver\/biliary\/pancreas (19.1%), and breast (10.2%). For non-malignant conditions, excess risk was noted overall (SMR 1.37, 95% CI [1.34, 1.40]) and for infectious (1.97 [1.85, 2.10]), renal (1.85 [1.60, 2.13]), cardio\/cerebrovascular (1.38 [1.33, 1.43]), and suicide (1.15 [1.04, 1.27]). Racial minorities were at significantly higher risk across all COD. Safer therapy, longitudinal monitoring, and primary\/secondary preventive strategies are needed to reduce late mortality in this vulnerable population.<\/jats:p>","DOI":"10.3390\/cancers13163956","type":"journal-article","created":{"date-parts":[[2021,8,5]],"date-time":"2021-08-05T09:35:32Z","timestamp":1628156132000},"page":"3956","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":24,"title":["A Population-Based Analysis of 30-Year Mortality among Five-Year Survivors of Adolescent and Young Adult Cancer: The Roles of Primary Cancer, Subsequent Malignancy, and Other Health Conditions"],"prefix":"10.3390","volume":"13","author":[{"given":"Diana J.","family":"Moke","sequence":"first","affiliation":[{"name":"Cancer and Blood Disease Institute, Children\u2019s Hospital Los Angeles, Los Angeles, CA 90027, USA"},{"name":"Department of Pediatrics, Keck School of Medicine, University of Southern California, Los Angeles, CA 90033, USA"},{"name":"Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA 90033, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ziwei","family":"Song","sequence":"additional","affiliation":[{"name":"Los Angeles Cancer Surveillance Program, University of Southern California, Los Angeles, CA 90089, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lihua","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA 90033, USA"},{"name":"Los Angeles Cancer Surveillance Program, University of Southern California, Los Angeles, CA 90089, USA"},{"name":"USC Norris Comprehensive Cancer Center, University of Southern California, Los Angeles, CA 90033, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ann S.","family":"Hamilton","sequence":"additional","affiliation":[{"name":"Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA 90033, USA"},{"name":"Los Angeles Cancer Surveillance Program, University of Southern California, Los Angeles, CA 90089, USA"},{"name":"USC Norris Comprehensive Cancer Center, University of Southern California, Los Angeles, CA 90033, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dennis","family":"Deapen","sequence":"additional","affiliation":[{"name":"Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA 90033, USA"},{"name":"Los Angeles Cancer Surveillance Program, University of Southern California, Los Angeles, CA 90089, USA"},{"name":"USC Norris Comprehensive Cancer Center, University of Southern California, Los Angeles, CA 90033, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5280-990X","authenticated-orcid":false,"given":"David R.","family":"Freyer","sequence":"additional","affiliation":[{"name":"Cancer and Blood Disease Institute, Children\u2019s Hospital Los Angeles, Los Angeles, CA 90027, USA"},{"name":"Department of Pediatrics, Keck School of Medicine, University of Southern California, Los Angeles, CA 90033, USA"},{"name":"Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA 90033, USA"},{"name":"USC Norris Comprehensive Cancer Center, University of Southern California, Los Angeles, CA 90033, USA"},{"name":"Department of Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA 90033, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2021,8,5]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"443","DOI":"10.3322\/caac.21637","article-title":"Cancer statistics for adolescents and young adults, 2020","volume":"70","author":"Miller","year":"2020","journal-title":"CA A Cancer J. 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