title: Subsequent hospitalisation experience of 5-year survivors of childhood, adolescent, and young adult cancer in Scotland: a population based, retrospective cohort study.
abstract: BACKGROUND
  Survivors of childhood, adolescent, and young adult cancer are known to be at risk of late effects of their disease and its treatment. Most population-based studies of cancer survivors have reported on second primary cancers and mortality. The aim of this study was to research acute and psychiatric hospital admission rates and length of stay in 5-year survivors of cancer diagnosed before the age of 25 years.
  
  
  METHODS
  This was a population-based retrospective cohort study using linked national cancer registry, acute hospital discharge, psychiatric hospital, and mortality records. The study population consisted of 5229 individuals who were diagnosed with cancer before the age of 25 years between 1981 and 2003, and who survived at least 5 years after the date of diagnosis of their primary cancer. Indirect standardisation for age and sex was used to calculate standardised bed days and hospitalisation ratios (SBDR and SHR) for both acute and psychiatric hospital admissions, and absolute excess risks (AERs) compared with the general Scottish population.
  
  
  RESULTS
  Five-year survivors of cancer, diagnosed before the age of 25 years, are at increased risk of admission to acute hospitals (SHR 2.8; 95% confidence interval 2.7-2.9) and of spending more time in hospital (SBDR 3.7; 3.6-3.7). Corresponding AERs were 6.4 (6.0-6.6) admissions and 64.8 (64.4-66.9) bed days per 100 cancer survivors per year. In contrast, 5-year survivors were not at higher risk of admission to psychiatric hospital (SHR 0.9; 0.8-1.2), and they spent significantly less time as psychiatric in-patients (SBDR 0.4; 0.4-0.4) compared with the whole population.
  
  
  CONCLUSIONS
  Using routinely collected linked records, our population-based study has demonstrated increased rates of hospitalisation in 5-year survivors of cancer diagnosed before the age of 25 years. Long-term clinical follow-up of survivors of cancer in this age group should focus on the prevention and treatment of the late effects of cancer in those patients at highest risk of hospitalisation.
authors.affiliation: 1] Information Services Division, NHS National Services Scotland, Gyle Square, 1 South Gyle Crescent, Edinburgh EH12 9EB, Scotland, UK [2] Centre for Population Health Sciences, University of Edinburgh, Edinburgh, Scotland, UK.
authors.forename: D H
authors.initials: DH
authors.lastname: Brewster
authors.affiliation: Information Services Division, NHS National Services Scotland, Gyle Square, 1 South Gyle Crescent, Edinburgh EH12 9EB, Scotland, UK.
authors.forename: D
authors.initials: D
authors.lastname: Clark
authors.affiliation: Information Services Division, NHS National Services Scotland, Gyle Square, 1 South Gyle Crescent, Edinburgh EH12 9EB, Scotland, UK.
authors.forename: L
authors.initials: L
authors.lastname: Hopkins
authors.affiliation: Information Services Division, NHS National Services Scotland, Gyle Square, 1 South Gyle Crescent, Edinburgh EH12 9EB, Scotland, UK.
authors.forename: J
authors.initials: J
authors.lastname: Bauer
authors.affiliation: Centre for Population Health Sciences, University of Edinburgh, Edinburgh, Scotland, UK.
authors.forename: S H
authors.initials: SH
authors.lastname: Wild
authors.affiliation: Department of Haematology/Oncology, Royal Hospital for Sick Children, Edinburgh, Scotland, UK.
authors.forename: A B
authors.initials: AB
authors.lastname: Edgar
authors.affiliation: Department of Haematology/Oncology, Royal Hospital for Sick Children, Edinburgh, Scotland, UK.
authors.forename: W H
authors.initials: WH
authors.lastname: Wallace
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D009369:Neoplasms / Q000453:epidemiology* / Q000401:mortality; D012189:Retrospective Studies; D012606:Scotland / Q000453:epidemiology; D017741:Survivors / Q000706:statistics & numerical data; D055815:Young Adult