title: Late new morbidity in survivors of adolescent and young-adulthood brain tumors in Finland: a registry-based study.
abstract: BACKGROUND
  Brain tumors (BTs) in adolescence and young adulthood (AYA) differ from those in childhood or late adulthood. However, research concerning late effects in this particular survivor group is limited. This study evaluates late morbidity of survivors diagnosed in AYAs.
  
  
  METHODS
  We identified from the Finnish Cancer Registry all survivors diagnosed with BT at the ages 16-24 years between 1970 and 2004 (N = 315) and used data from the Hospital Discharge Registry to evaluate their late (≥5 y after diagnosis) morbidity requiring treatment in a specialized health care setting. A sibling cohort of BT patients diagnosed before the age of 25 years was used as a comparison cohort (N = 3615).
  
  
  RESULTS
  The AYA BT survivors had an increased risk for late-appearing endocrine diseases (HR, 2.9; 95% CI, 1.1-8.0), psychiatric disorders (HR, 2.0; 95% CI, 1.2-3.2), diseases of the nervous system (HR, 9; 95% CI, 6.6-14.0), disorders of vision/hearing loss (HR, 3.6; 95% CI, 1.5-8.5), diseases of the circulatory system (HR, 4.9; 95% CI, 2.9-8.1), and diseases of the kidney (HR, 5.9; 95% CI, 2.5-14.1). Survivors with irradiation had an increased risk for diseases of the nervous system compared with non-irradiated survivors (HR, 3.3; 95% CI, 1.8-6.2). The cumulative prevalence for most of the diagnoses remained significantly increased for survivors even 20 years after cancer diagnosis.
  
  
  CONCLUSIONS
  The AYA BT survivors have an increased risk of morbidity for multiple new outcomes for ≥5 years after their primary diagnosis. This emphasizes the need for structured late-effect follow-up for this patient group.
authors.affiliation: Department of Pediatrics, Turku University Hospital, Turku, Finland (M.E.G., M.G., P.M.L.); Finnish Cancer Registry, Helsinki, Finland (N.M.); School of Health Sciences, University of Tampere, Tampere, Finland (N.M.); Division of Pediatric Neurology, Department of Pediatrics, Turku University Hospital, Turku, Finland (T.L.); Department of Pediatrics, Tampere University Hospital, Tampere, Finland (M.A.); Clinical Research Centre, Turku University Hospital, Turku, Finland (M.J.).
authors.forename: Mirja Erika
authors.initials: ME
authors.lastname: Gunn
authors.affiliation: Department of Pediatrics, Turku University Hospital, Turku, Finland (M.E.G., M.G., P.M.L.); Finnish Cancer Registry, Helsinki, Finland (N.M.); School of Health Sciences, University of Tampere, Tampere, Finland (N.M.); Division of Pediatric Neurology, Department of Pediatrics, Turku University Hospital, Turku, Finland (T.L.); Department of Pediatrics, Tampere University Hospital, Tampere, Finland (M.A.); Clinical Research Centre, Turku University Hospital, Turku, Finland (M.J.).
authors.forename: Nea
authors.initials: N
authors.lastname: Malila
authors.affiliation: Department of Pediatrics, Turku University Hospital, Turku, Finland (M.E.G., M.G., P.M.L.); Finnish Cancer Registry, Helsinki, Finland (N.M.); School of Health Sciences, University of Tampere, Tampere, Finland (N.M.); Division of Pediatric Neurology, Department of Pediatrics, Turku University Hospital, Turku, Finland (T.L.); Department of Pediatrics, Tampere University Hospital, Tampere, Finland (M.A.); Clinical Research Centre, Turku University Hospital, Turku, Finland (M.J.).
authors.forename: Tuire
authors.initials: T
authors.lastname: Lähdesmäki
authors.affiliation: Department of Pediatrics, Turku University Hospital, Turku, Finland (M.E.G., M.G., P.M.L.); Finnish Cancer Registry, Helsinki, Finland (N.M.); School of Health Sciences, University of Tampere, Tampere, Finland (N.M.); Division of Pediatric Neurology, Department of Pediatrics, Turku University Hospital, Turku, Finland (T.L.); Department of Pediatrics, Tampere University Hospital, Tampere, Finland (M.A.); Clinical Research Centre, Turku University Hospital, Turku, Finland (M.J.).
authors.forename: Mikko
authors.initials: M
authors.lastname: Arola
authors.affiliation: Department of Pediatrics, Turku University Hospital, Turku, Finland (M.E.G., M.G., P.M.L.); Finnish Cancer Registry, Helsinki, Finland (N.M.); School of Health Sciences, University of Tampere, Tampere, Finland (N.M.); Division of Pediatric Neurology, Department of Pediatrics, Turku University Hospital, Turku, Finland (T.L.); Department of Pediatrics, Tampere University Hospital, Tampere, Finland (M.A.); Clinical Research Centre, Turku University Hospital, Turku, Finland (M.J.).
authors.forename: Marika
authors.initials: M
authors.lastname: Grönroos
authors.affiliation: Department of Pediatrics, Turku University Hospital, Turku, Finland (M.E.G., M.G., P.M.L.); Finnish Cancer Registry, Helsinki, Finland (N.M.); School of Health Sciences, University of Tampere, Tampere, Finland (N.M.); Division of Pediatric Neurology, Department of Pediatrics, Turku University Hospital, Turku, Finland (T.L.); Department of Pediatrics, Tampere University Hospital, Tampere, Finland (M.A.); Clinical Research Centre, Turku University Hospital, Turku, Finland (M.J.).
authors.forename: Jaakko
authors.initials: J
authors.lastname: Matomäki
authors.affiliation: Department of Pediatrics, Turku University Hospital, Turku, Finland (M.E.G., M.G., P.M.L.); Finnish Cancer Registry, Helsinki, Finland (N.M.); School of Health Sciences, University of Tampere, Tampere, Finland (N.M.); Division of Pediatric Neurology, Department of Pediatrics, Turku University Hospital, Turku, Finland (T.L.); Department of Pediatrics, Tampere University Hospital, Tampere, Finland (M.A.); Clinical Research Centre, Turku University Hospital, Turku, Finland (M.J.).
authors.forename: Päivi Maria
authors.initials: PM
authors.lastname: Lähteenmäki
mesh_terms: D000293:Adolescent; D000328:Adult; D001766:Blindness / Q000453:epidemiology; D001932:Brain Neoplasms / Q000453:epidemiology* / Q000401:mortality; D002493:Central Nervous System Diseases / Q000453:epidemiology; D004700:Endocrine System Diseases / Q000453:epidemiology; D005260:Female; D005387:Finland; D034381:Hearing Loss / Q000453:epidemiology; D006801:Humans; D007674:Kidney Diseases / Q000453:epidemiology; D008297:Male; D001523:Mental Disorders / Q000453:epidemiology; D009017:Morbidity; D009140:Musculoskeletal Diseases / Q000453:epidemiology; D016016:Proportional Hazards Models; D012042:Registries; D012307:Risk Factors; D035781:Siblings; D017741:Survivors; D013997:Time Factors; D055815:Young Adult
keywords: adolescence; brain tumor; late effect; survivor; young adult