SMRs and AERs per 10 000 person-years for chronic lower respiratory mortality, fibrosis mortality, pneumonitis mortality and other respiratory mortality by potential explanatory factors, for the Teenage and Young Adult Cancer Survivor Study†
| Chronic lower respiratory disease | Fibrosis | Pneumonitis | Other respiratory | |||||||||
| O/E | SMR (95% CI) | AER (95% CI) | O/E | SMR (95% CI) | AER (95% CI) | O/E | SMR (95% CI) | AER (95% CI) | O/E | SMR (95% CI) | AER (95% CI) | |
| Overall | 393/295.0 | 1.3 (1.2 to 1.5) | 0.3 (0.2 to 0.5) | 74/42.7 | 1.7 (1.4 to 2.2) | 0.1 (0.1 to 0.2) | 49/22.5 | 2.2 (1.6 to 2.9) | 0.1 (0.0 to 0.1) | 168/91.9 | 1.8 (1.6 to 2.1) | 0.3 (0.2 to 0.4) |
| Sex | ||||||||||||
| Male | 146/112.1 | 1.3 (1.1 to 1.5) | 0.3 (0.1 to 0.5) | 29/20.7 | 1.4 (0.9 to 2.0) | 0.1 (−0.0 to 0.2) | 28/10.3 | 2.7 (1.8 to 3.9) | 0.2 (0.1 to 0.3) | 86/36.1 | 2.4 (1.9 to 2.9) | 0.5 (0.3 to 0.6) |
| Female | 247/183.0 | 1.4 (1.2 to 1.5) | 0.4 (0.2 to 0.5) | 45/22.0 | 2.0 (1.5 to 2.7) | 0.1 (0.1 to 0.2) | 21/12.2 | 1.7 (1.1 to 2.6) | 0.0 (−0.0 to 0.1) | 82/55.8 | 1.5 (1.2 to 1.8) | 0.1 (0.0 to 0.2) |
| P hetero* | 0.2252 | 0.3215 | 0.0007 | 0.0040 | 0.7433 | 0.2161 | 0.2266 | 0.1113 | ||||
| First primary neoplasm type | ||||||||||||
| Breast | 56/58.4 | 1.0 (0.7 to 1.2) | −0.1 (−0.4 to 0.3) | 8/7.0 | 1.2 (0.5 to 2.3) | 0.0 (−0.1 to 0.1) | 4/3.6 | 1.1 (0.3 to 2.8) | 0.0 (−0.1 to 0.1) | 23/16.6 | 1.4 (0.9 to 2.1) | 0.1 (−0.1 to 0.4) |
| Testicular | 37/32.7 | 1.1 (0.8 to 1.6) | 0.1 (−0.2 to 0.5) | 9/6.1 | 1.5 (0.7 to 2.8) | 0.1 (−0.1 to 0.2) | 3/3.2 | 0.9 (0.2 to 2.7) | −0.0 (−0.1 to 0.1) | 15/11.2 | 1.3 (0.8 to 2.2) | 0.1 (−0.1 to 0.3) |
| Cervical | 87/41.6 | 2.1 (1.7 to 2.6) | 1.2 (0.7 to 1.7) | 7/5.0 | 1.4 (0.6 to 2.9) | 0.1 (−0.1 to 0.2) | 2/2.8 | 0.7 (0.1 to 2.6) | −0.0 (−0.1 to 0.1) | 12/12.5 | 1.0 (0.5 to 1.7) | −0.0 (−0.2 to 0.2) |
| Melanoma | 13/25.7 | 0.5 (0.3 to 0.9) | −0.4 (−0.7 to −0.2) | 2/3.7 | 0.5 (0.1 to 2.0) | −0.1 (−0.2 to 0.0) | 2/2.1 | 0.9 (0.1 to 3.4) | −0.0 (−0.1 to 0.1) | 3/8.5 | 0.4 (0.1 to 1.0) | −0.2 (−0.3 to -0.1) |
| CNS tumour | 21/18.1 | 1.2 (0.7 to 1.8) | 0.1 (−0.3 to 0.5) | 3/2.8 | 1.1 (0.2 to 3.1) | 0.0 (−0.1 to 0.2) | 20/1.6 | 12.8 (7.8 to 19.8) | 0.8 (0.4 to 1.2) | 27/6.3 | 4.3 (2.8 to 6.2) | 0.9 (0.5 to 1.3) |
| Hodgkin’s lymphoma | 40/17.4 | 2.3 (1.6 to 3.1) | 0.8 (0.4 to 1.3) | 19/2.8 | 6.7 (4.0 to 10.4) | 0.6 (0.3 to 0.9) | 3/1.6 | 1.8 (0.4 to 5.4) | 0.1 (−0.1 to 0.2) | 33/6.7 | 4.9 (3.4 to 6.9) | 1.0 (0.6 to 1.4) |
| Non-Hodgkin’s lymphoma | 15/11.3 | 1.3 (0.7 to 2.2) | 0.3 (−0.3 to 0.9) | 4/1.8 | 2.2 (0.6 to 5.5) | 0.2 (−0.1 to 0.5) | 3/1.0 | 3.1 (0.6 to 9.0) | 0.2 (−0.1 to 0.4) | 20/3.7 | 5.3 (3.3 to 8.2) | 1.3 (0.6 to 2.0) |
| Thyroid | 6/9.6 | 0.6 (0.2 to 1.4) | −0.3 (−0.7 to 0.1) | 0/1.3 | – | – | 0/0.7 | – | – | 3/3.1 | 1.0 (0.2 to 2.8) | −0.0 (−0.3 to 0.3) |
| Gastrointestinal | 20/16.0 | 1.3 (0.8 to 1.9) | 0.4 (−0.5 to 1.2) | 3/2.4 | 1.2 (0.3 to 3.6) | 0.1 (−0.3 to 0.4) | 0/1.1 | – | – | 7/4.3 | 1.6 (0.7 to 3.4) | 0.3 (−0.2 to 0.8) |
| Soft tissue sarcoma | 13/9.2 | 1.4 (0.8 to 2.4) | 0.4 (−0.4 to 1.2) | 1/1.4 | 0.7 (0.0 to 4.0) | −0.0 (−0.3 to 0.2) | 1/0.7 | 1.4 (0.0 to 7.7) | 0.0 (−0.2 to 0.2) | 2/2.9 | 0.7 (0.1 to 2.5) | −0.1 (−0.4 to 0.2) |
| Ovary | 7/8.9 | 0.8 (0.3 to 1.6) | −0.2 (−0.9 to 0.4) | 0/1.1 | – | – | 0/0.6 | – | – | 3/2.6 | 1.2 (0.2 to 3.4) | 0.0 (−0.4 to 0.5) |
| Bladder | 16/15.0 | 1.1 (0.6 to 1.7) | 0.1 (−0.8 to 1.1) | 3/2.6 | 1.2 (0.2 to 3.4) | 0.1 (−0.4 to 0.5) | 0/1.1 | – | – | 1/3.8 | 0.3 (0.0 to 1.5) | −0.3 (−0.6 to -0.1) |
| Other genitourinary | 14/10.4 | 1.3 (0.7 to 2.3) | 0.5 (−0.5 to 1.6) | 4/1.4 | 2.8 (0.8 to 7.1) | 0.4 (−0.2 to 0.9) | 1/0.7 | 1.5 (0.0 to 8.1) | 0.0 (−0.2 to 0.3) | 3/2.8 | 1.1 (0.2 to 3.1) | 0.0 (−0.5 to 0.5) |
| Head and neck | 16/7.6 | 2.1 (1.2 to 3.4) | 1.5 (0.1 to 2.8) | 1/1.2 | 0.8 (0.0 to 4.5) | −0.0 (−0.4 to 0.3) | 5/0.6 | 8.8 (2.9 to 20.6) | 0.8 (0.0 to 1.5) | 3/2.1 | 1.4 (0.3 to 4.1) | 0.1 (−0.4 to 0.7) |
| Leukaemia (excluding AML) | 6/2.0 | 3.0 (1.1 to 6.6) | 1.0 (−0.2 to 2.2) | 4/0.3 | 12.1 (3.3 to 31.0) | 0.9 (−0.1 to 1.9) | 3/0.2 | 13.7 (2.8 to 39.9) | 0.7 (−0.2 to 1.6) | 3/0.9 | 3.4 (0.7 to 10.0) | 0.5 (−0.3 to 1.4) |
| Other | 8/5.3 | 1.5 (0.6 to 2.9) | 0.5 (−0.6 to 1.7) | 1/0.8 | 1.2 (0.0 to 6.9) | 0.0 (−0.4 to 0.4) | 1/0.4 | 2.5 (0.1 to 14.0) | 0.1 (−0.3 to 0.5) | 2/1.6 | 1.2 (0.2 to 4.5) | 0.1 (−0.5 to 0.6) |
| Bone tumour | 1/1.8 | 0.6 (0.0 to 3.1) | −0.2 (−0.8 to 0.3) | 1/0.3 | 3.3 (0.1 to 18.3) | 0.2 (−0.4 to 0.8) | 1/0.2 | 5.4 (0.1 to 30.0) | 0.2 (−0.3 to 0.8) | 0/0.8 | – | – |
| AML | 1/0.7 | 1.4 (0.0 to 7.6) | 0.1 (−0.8 to 1.1) | 3/0.1 | 24.1 (5.0 to 70.6) | 1.4 (−0.3 to 3.1) | 0/0.1 | – | – | 5/0.4 | 12.6 (4.1 to 29.3) | 2.2 (0.1 to 4.4) |
| Lung | 16/3.3 | 4.8 (2.7 to 7.8) | 6.6 (2.5 to 10.6) | 1/0.5 | 1.8 (0.0 to 10.2) | 0.2 (−0.8 to 1.3) | 0/0.2 | – | – | 3/0.9 | 3.5 (0.7 to 10.1) | 1.1 (−0.7 to 2.9) |
| P hetero* | <0.0001 | <0.0001 | <0.0001 | 0.0001 | <0.0001 | <0.0001 | <0.0001 | <0.0001 | ||||
| Age at diagnosis (years) | ||||||||||||
| 15–19 | 9/1.6 | 5.6 (2.6 to 10.6) | 0.4 (0.1 to 0.7) | 8/0.4 | 21.5 (9.3 to 42.3) | 0.4 (0.1 to 0.7) | 4/0.5 | 8.4 (2.3 to 21.4) | 0.2 (−0.0 to 0.4) | 15/2.4 | 6.3 (3.5 to 10.4) | 0.7 (0.3 to 1.0) |
| 20–24 | 18/6.9 | 2.6 (1.5 to 4.1) | 0.3 (0.1 to 0.6) | 9/1.3 | 7.1 (3.2 to 13.4) | 0.2 (0.1 to 0.4) | 7/1.2 | 5.9 (2.4 to 12.1) | 0.2 (0.0 to 0.3) | 16/5.3 | 3.0 (1.7 to 4.9) | 0.3 (0.1 to 0.6) |
| 25–29 | 30/25.3 | 1.2 (0.8 to 1.7) | 0.1 (−0.1 to 0.3) | 7/4.0 | 1.7 (0.7 to 3.6) | 0.1 (−0.0 to 0.2) | 8/2.8 | 2.8 (1.2 to 5.5) | 0.1 (−0.0 to 0.2) | 27/11.8 | 2.3 (1.5 to 3.3) | 0.3 (0.1 to 0.5) |
| 30–34 | 85/73.2 | 1.2 (0.9 to 1.4) | 0.2 (−0.1 to 0.4) | 21/10.8 | 1.9 (1.2 to 3.0) | 0.1 (0.0 to 0.2) | 10/6.0 | 1.7 (0.8 to 3.1) | 0.1 (−0.0 to 0.1) | 39/24.0 | 1.6 (1.2 to 2.2) | 0.2 (0.0 to 0.4) |
| 35–39 | 251/188.0 | 1.3 (1.2 to 1.5) | 0.6 (0.3 to 0.9) | 29/26.2 | 1.1 (0.7 to 1.6) | 0.0 (−0.1 to 0.1) | 20/12.0 | 1.7 (1.0 to 2.6) | 0.1 (−0.0 to 0.2) | 71/48.3 | 1.5 (1.1 to 1.9) | 0.2 (0.1 to 0.4) |
| P trend* | 0.8584 | 0.3593 | 0.3378 | 0.1290 | 0.4927 | 0.1572 | 0.0340 | 0.2243 | ||||
| Treatment era | ||||||||||||
| 1970–1979 | 210/160.9 | 1.3 (1.1 to 1.5) | 0.7 (0.3 to 1.2) | 28/22.5 | 1.2 (0.8 to 1.8) | 0.1 (−0.1 to 0.2) | 23/8.6 | 2.7 (1.7 to 4.0) | 0.2 (0.1 to 0.4) | 47/37.6 | 1.3 (0.9 to 1.7) | 0.1 (−0.1 to 0.3) |
| 1980–1989 | 146/105.4 | 1.4 (1.2 to 1.6) | 0.4 (0.2 to 0.6) | 27/14.7 | 1.8 (1.2 to 2.7) | 0.1 (0.0 to 0.2) | 14/8.2 | 1.7 (0.9 to 2.9) | 0.1 (−0.0 to 0.1) | 68/33.1 | 2.1 (1.6 to 2.6) | 0.3 (0.2 to 0.5) |
| 1990–1999 | 33/25.4 | 1.3 (0.9 to 1.8) | 0.1 (−0.0 to 0.2) | 17/4.7 | 3.6 (2.1 to 5.8) | 0.1 (0.0 to 0.2) | 9/4.5 | 2.0 (0.9 to 3.8) | 0.1 (−0.0 to 0.1) | 42/16.9 | 2.5 (1.8 to 3.4) | 0.3 (0.1 to 0.4) |
| 2000–2006 | 4/3.3 | 1.2 (0.3 to 3.1) | 0.0 (−0.1 to 0.2) | 2/0.9 | 2.3 (0.3 to 8.5) | 0.0 (−0.1 to 0.1) | 3/1.2 | 2.6 (0.5 to 7.5) | 0.1 (−0.1 to 0.2) | 11/4.3 | 2.5 (1.3 to 4.5) | 0.2 (0.0 to 0.4) |
| P trend* | 0.2334 | 0.0024 | 0.6104 | 0.9954 | 0.0942 | 0.5108 | 0.0066 | 0.1235 | ||||
| Attained age (years) | ||||||||||||
| 20–29 | 2/0.1 | 16.2 (2.0 to 58.7) | 0.1 (−0.1 to 0.4) | 2/0.1 | 39.2 (4.7 to 141.5) | 0.2 (−0.1 to 0.4) | 1/0.1 | 8.1 (0.2 to 45.3) | 0.1 (−0.1 to 0.2) | 7/1.0 | 6.7 (2.7 to 13.8) | 0.5 (0.1 to 0.9) |
| 30–39 | 7/1.7 | 4.1 (1.7 to 8.5) | 0.1 (0.0 to 0.2) | 14/0.6 | 22.4 (12.3 to 37.6) | 0.2 (0.1 to 0.4) | 7/1.0 | 6.8 (2.7 to 14.1) | 0.1 (0.0 to 0.2) | 21/6.8 | 3.1 (1.9 to 4.7) | 0.2 (0.1 to 0.4) |
| 40–49 | 38/21.6 | 1.8 (1.2 to 2.4) | 0.1 (0.0 to 0.2) | 13/4.4 | 2.9 (1.6 to 5.0) | 0.1 (0.0 to 0.1) | 12/4.5 | 2.7 (1.4 to 4.7) | 0.1 (0.0 to 0.1) | 52/25.7 | 2.0 (1.5 to 2.7) | 0.2 (0.1 to 0.3) |
| 50–59 | 122/82.3 | 1.5 (1.2 to 1.8) | 0.6 (0.3 to 0.9) | 23/10.9 | 2.1 (1.3 to 3.2) | 0.2 (0.0 to 0.3) | 10/6.9 | 1.5 (0.7 to 2.7) | 0.0 (−0.0 to 0.1) | 50/28.3 | 1.8 (1.3 to 2.3) | 0.3 (0.1 to 0.5) |
| 60+ | 224/189.3 | 1.2 (1.0 to 1.3) | 1.3 (0.2 to 2.3) | 22/26.7 | 0.8 (0.5 to 1.2) | −0.2 (−0.5 to 0.2) | 19/10.0 | 1.9 (1.1 to 3.0) | 0.3 (0.0 to 0.6) | 38/30.1 | 1.3 (0.9 to 1.7) | 0.3 (−0.2 to 0.7) |
| P trend* | 0.0005 | <0.0001 | <0.0001 | 0.3255 | 0.0866 | 0.0078 | 0.8761 | 0.0070 | ||||
*P heterogeneity and p trend were calculated by using likelihood ratio tests within multivariable Poisson regression models that adjusted for sex, first primary neoplasm type, age at diagnosis, treatment era and attained age.
†Strata with less than five observed events should be interpreted with caution.
AER, absolute excess risk; AML, acute myeloid leukaemia; CNS, central nervous system; E, expected; O, observed; PNETs, primitive neuroectodermal tumour; SMR, standardised mortality ratio.