title: Hospitalization Rates Among Survivors of Young Adult Malignancies.
abstract: OBJECTIVE
  There are limited data on health care use among survivors of young adult cancers. We aimed to describe patterns of hospitalization among a cohort of long-term survivors compared with noncancer controls.
  
  
  METHODS
  Persons diagnosed between the ages of 20 and 44 years with malignancies in Ontario, Canada, from 1992 to 1999, who lived at least 5 years recurrence free, were identified using the Ontario Cancer Registry and matched to noncancer controls. Hospitalizations were determined using hospital discharges, and rates were compared between survivors and controls. The absolute excess rate of hospitalizations was determined for each type of malignancy in survivors per 100 person-years of follow-up.
  
  
  RESULTS
  The cohort included 20,275 survivors and 101,344 noncancer controls. During the study period, 6,948 (34.3%) survivors were admitted to the hospital and the adjusted relative rate (ARR) of hospitalizations in survivors compared with controls was 1.51 (95% CI, 1.48 to 1.54). The rate of hospitalization was highest for survivors of upper GI, leukemia, and urologic malignancies. The hospitalization rate (per person) for survivors significantly decreased from 0.22 in the first time period examined (5 to 8 years after diagnosis) to 0.15 in the last time period examined (18 to 20 years after diagnosis, P < .0001). However, at all time periods, survivors were more likely to be hospitalized than controls (ARR at 5 to 8 years, 1.67 [95% CI, 1.57 to 1.81]; ARR at 18 to 20 years, 1.22 [95% CI, 1.08 to 1.37]).
  
  
  CONCLUSIONS
  Survivors of young adult cancers have an increased rate of hospitalization compared with controls. The rate of hospitalization for 20-year survivors did not return to baseline, indicating a substantial and persistent burden of late effects among this generally young population.
authors.affiliation: Devon P. Richardson, Rinku Sutradhar, Lawrence F. Paszat, Linda Rabeneck, and Nancy N. Baxter, University of Toronto, Toronto, Ontario, Canada; Rinku Sutradhar, Lawrence F. Paszat, Andrew S. Wilton, Linda Rabeneck, and Nancy N. Baxter, Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada; Corinne Daly and Nancy N. Baxter, St Michael's Hospital, Toronto, Ontario, Canada; Lawrence F. Paszat and Linda Rabeneck, Sunnybrook Research Institute, Toronto, Ontario, Canada; and Linda Rabeneck, Cancer Care Ontario, Toronto, Ontario, Canada.
authors.forename: Devon P
authors.initials: DP
authors.lastname: Richardson
authors.affiliation: Devon P. Richardson, Rinku Sutradhar, Lawrence F. Paszat, Linda Rabeneck, and Nancy N. Baxter, University of Toronto, Toronto, Ontario, Canada; Rinku Sutradhar, Lawrence F. Paszat, Andrew S. Wilton, Linda Rabeneck, and Nancy N. Baxter, Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada; Corinne Daly and Nancy N. Baxter, St Michael's Hospital, Toronto, Ontario, Canada; Lawrence F. Paszat and Linda Rabeneck, Sunnybrook Research Institute, Toronto, Ontario, Canada; and Linda Rabeneck, Cancer Care Ontario, Toronto, Ontario, Canada.
authors.forename: Corinne
authors.initials: C
authors.lastname: Daly
authors.affiliation: Devon P. Richardson, Rinku Sutradhar, Lawrence F. Paszat, Linda Rabeneck, and Nancy N. Baxter, University of Toronto, Toronto, Ontario, Canada; Rinku Sutradhar, Lawrence F. Paszat, Andrew S. Wilton, Linda Rabeneck, and Nancy N. Baxter, Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada; Corinne Daly and Nancy N. Baxter, St Michael's Hospital, Toronto, Ontario, Canada; Lawrence F. Paszat and Linda Rabeneck, Sunnybrook Research Institute, Toronto, Ontario, Canada; and Linda Rabeneck, Cancer Care Ontario, Toronto, Ontario, Canada.
authors.forename: Rinku
authors.initials: R
authors.lastname: Sutradhar
authors.affiliation: Devon P. Richardson, Rinku Sutradhar, Lawrence F. Paszat, Linda Rabeneck, and Nancy N. Baxter, University of Toronto, Toronto, Ontario, Canada; Rinku Sutradhar, Lawrence F. Paszat, Andrew S. Wilton, Linda Rabeneck, and Nancy N. Baxter, Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada; Corinne Daly and Nancy N. Baxter, St Michael's Hospital, Toronto, Ontario, Canada; Lawrence F. Paszat and Linda Rabeneck, Sunnybrook Research Institute, Toronto, Ontario, Canada; and Linda Rabeneck, Cancer Care Ontario, Toronto, Ontario, Canada.
authors.forename: Lawrence F
authors.initials: LF
authors.lastname: Paszat
authors.affiliation: Devon P. Richardson, Rinku Sutradhar, Lawrence F. Paszat, Linda Rabeneck, and Nancy N. Baxter, University of Toronto, Toronto, Ontario, Canada; Rinku Sutradhar, Lawrence F. Paszat, Andrew S. Wilton, Linda Rabeneck, and Nancy N. Baxter, Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada; Corinne Daly and Nancy N. Baxter, St Michael's Hospital, Toronto, Ontario, Canada; Lawrence F. Paszat and Linda Rabeneck, Sunnybrook Research Institute, Toronto, Ontario, Canada; and Linda Rabeneck, Cancer Care Ontario, Toronto, Ontario, Canada.
authors.forename: Andrew S
authors.initials: AS
authors.lastname: Wilton
authors.affiliation: Devon P. Richardson, Rinku Sutradhar, Lawrence F. Paszat, Linda Rabeneck, and Nancy N. Baxter, University of Toronto, Toronto, Ontario, Canada; Rinku Sutradhar, Lawrence F. Paszat, Andrew S. Wilton, Linda Rabeneck, and Nancy N. Baxter, Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada; Corinne Daly and Nancy N. Baxter, St Michael's Hospital, Toronto, Ontario, Canada; Lawrence F. Paszat and Linda Rabeneck, Sunnybrook Research Institute, Toronto, Ontario, Canada; and Linda Rabeneck, Cancer Care Ontario, Toronto, Ontario, Canada.
authors.forename: Linda
authors.initials: L
authors.lastname: Rabeneck
authors.affiliation: Devon P. Richardson, Rinku Sutradhar, Lawrence F. Paszat, Linda Rabeneck, and Nancy N. Baxter, University of Toronto, Toronto, Ontario, Canada; Rinku Sutradhar, Lawrence F. Paszat, Andrew S. Wilton, Linda Rabeneck, and Nancy N. Baxter, Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada; Corinne Daly and Nancy N. Baxter, St Michael's Hospital, Toronto, Ontario, Canada; Lawrence F. Paszat and Linda Rabeneck, Sunnybrook Research Institute, Toronto, Ontario, Canada; and Linda Rabeneck, Cancer Care Ontario, Toronto, Ontario, Canada. baxtern@smh.ca.
authors.forename: Nancy N
authors.initials: NN
authors.lastname: Baxter
mesh_terms: D000328:Adult; D015331:Cohort Studies; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D009369:Neoplasms / Q000453:epidemiology* / Q000628:therapy*; D009864:Ontario / Q000453:epidemiology; D016019:Survival Analysis