title: Conditional survival in pediatric malignancies: analysis of data from the Childhood Cancer Survivor Study and the Surveillance, Epidemiology, and End Results Program.
abstract: BACKGROUND
  Long-term survivors of pediatric cancer are at risk of life-threatening late effects of their cancer. Previous studies have shown excesses in long-term mortality within high-risk groups defined by demographic and treatment characteristics.
  
  
  METHODS
  To investigate conditional survival in a pediatric cancer population, the authors performed an analysis of conditional survival in the original Childhood Cancer Survivor Study (CCSS) cohort and the Surveillance, Epidemiology, and End Results (SEER) database registry. The overall probability of death for patients at 5 years and 10 years after they survived 5, 10, 15, and 20 years since cancer diagnosis and cause-specific death in 10 years for 5-year survivors were estimated using the cumulative incidence method.
  
  
  RESULTS
  Among patients in the CCSS and SEER cohorts who were alive 5 years after their cancer diagnosis, within each diagnosis group at least 92% were alive in the subsequent 5 years, except for patients with leukemia, of whom only 88% of 5-year survivors remained alive in the subsequent 5 years. The probability of all-cause mortality in the next 10 years among patients who survived at least 5 years after diagnosis was 8.8% in CCSS and 10.6% in SEER, approximately 75% of which was due to neoplasms as the cause of death.
  
  
  CONCLUSIONS
  The risk of death among survivors of pediatric cancer in 10 years can vary between diagnosis groups by at most 12%, even up to 20 years after diagnosis. This information is clinically significant when counseling patients regarding their conditional survival, particularly when survivors are seen in long-term follow-up.
authors.affiliation: Aflac Cancer and Blood Disorders Center, Children's Healthcare of Atlanta, Emory University, Atlanta, Georgia.
authors.forename: Ann C
authors.initials: AC
authors.lastname: Mertens
authors.forename: Jian
authors.initials: J
authors.lastname: Yong
authors.forename: Andrew C
authors.initials: AC
authors.lastname: Dietz
authors.forename: Erin
authors.initials: E
authors.lastname: Kreiter
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Yasui
authors.forename: Archie
authors.initials: A
authors.lastname: Bleyer
authors.forename: Gregory T
authors.initials: GT
authors.lastname: Armstrong
authors.forename: Leslie L
authors.initials: LL
authors.lastname: Robison
authors.forename: Karen
authors.initials: K
authors.lastname: Wasilewski-Masker
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D015987:Effect Modifier, Epidemiologic; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D009026:Mortality / Q000639:trends*; D009369:Neoplasms / Q000175:diagnosis / Q000401:mortality*; D011379:Prognosis; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D018426:SEER Program; D015996:Survival Rate; D017741:Survivors / Q000706:statistics & numerical data*; D013997:Time Factors; D055815:Young Adult
keywords: cause-specific mortality; cohort study; conditional survival; pediatric cancer; survivors