Evidence map›Paper›PMID 28082386›Full record

ArticleCirculation2017

Population-Based Long-Term Cardiac-Specific Mortality Among 34 489 Five-Year Survivors of Childhood Cancer in Great Britain.

Miranda M Fidler, Raoul C Reulen, Katherine Henson, Julie Kelly, David Cutter, Gill A Levitt, Clare Frobisher, David L Winter, Michael M Hawkins, British Childhood Cancer Survivor Study (BCCSS) Steering Group

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In one paragraph

Article in Circulation, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 57 papers, 6 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
57citing papers in PubMed, 6 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

57 citing papers in PubMed, 6 syntheses or guidelines pooled it.

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  15. Cancer and Heart Failure: Dangerous Liaisons.Journal of cardiovascular development and disease · 2024
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

Miranda M FidlerFrom Centre for Childhood Cancer Survivor Studies, Institute of Applied Health Research, University of Birmingham, Birmingham, UK (M.M.F., R.C.R., K.H., J.K., C.F., D.L.W., M.M.H.); Nuffield Department of Population Health, University of Oxford, Oxford, UK (K.H., D.C.); Oxford Cancer and Haematology Centre, Oxford University Hospitals NHS Foundation Trust, Churchill Hospital, Headington, Oxford, UK (D.C.); and Great Ormond Street Hospital NHS Foundation Trust, London, UK (G.A.L.).
Raoul C ReulenFrom Centre for Childhood Cancer Survivor Studies, Institute of Applied Health Research, University of Birmingham, Birmingham, UK (M.M.F., R.C.R., K.H., J.K., C.F., D.L.W., M.M.H.); Nuffield Department of Population Health, University of Oxford, Oxford, UK (K.H., D.C.); Oxford Cancer and Haematology Centre, Oxford University Hospitals NHS Foundation Trust, Churchill Hospital, Headington, Oxford, UK (D.C.); and Great Ormond Street Hospital NHS Foundation Trust, London, UK (G.A.L.).
Katherine HensonFrom Centre for Childhood Cancer Survivor Studies, Institute of Applied Health Research, University of Birmingham, Birmingham, UK (M.M.F., R.C.R., K.H., J.K., C.F., D.L.W., M.M.H.); Nuffield Department of Population Health, University of Oxford, Oxford, UK (K.H., D.C.); Oxford Cancer and Haematology Centre, Oxford University Hospitals NHS Foundation Trust, Churchill Hospital, Headington, Oxford, UK (D.C.); and Great Ormond Street Hospital NHS Foundation Trust, London, UK (G.A.L.).
Julie KellyFrom Centre for Childhood Cancer Survivor Studies, Institute of Applied Health Research, University of Birmingham, Birmingham, UK (M.M.F., R.C.R., K.H., J.K., C.F., D.L.W., M.M.H.); Nuffield Department of Population Health, University of Oxford, Oxford, UK (K.H., D.C.); Oxford Cancer and Haematology Centre, Oxford University Hospitals NHS Foundation Trust, Churchill Hospital, Headington, Oxford, UK (D.C.); and Great Ormond Street Hospital NHS Foundation Trust, London, UK (G.A.L.).
David CutterFrom Centre for Childhood Cancer Survivor Studies, Institute of Applied Health Research, University of Birmingham, Birmingham, UK (M.M.F., R.C.R., K.H., J.K., C.F., D.L.W., M.M.H.); Nuffield Department of Population Health, University of Oxford, Oxford, UK (K.H., D.C.); Oxford Cancer and Haematology Centre, Oxford University Hospitals NHS Foundation Trust, Churchill Hospital, Headington, Oxford, UK (D.C.); and Great Ormond Street Hospital NHS Foundation Trust, London, UK (G.A.L.).
Gill A LevittFrom Centre for Childhood Cancer Survivor Studies, Institute of Applied Health Research, University of Birmingham, Birmingham, UK (M.M.F., R.C.R., K.H., J.K., C.F., D.L.W., M.M.H.); Nuffield Department of Population Health, University of Oxford, Oxford, UK (K.H., D.C.); Oxford Cancer and Haematology Centre, Oxford University Hospitals NHS Foundation Trust, Churchill Hospital, Headington, Oxford, UK (D.C.); and Great Ormond Street Hospital NHS Foundation Trust, London, UK (G.A.L.).
Clare FrobisherFrom Centre for Childhood Cancer Survivor Studies, Institute of Applied Health Research, University of Birmingham, Birmingham, UK (M.M.F., R.C.R., K.H., J.K., C.F., D.L.W., M.M.H.); Nuffield Department of Population Health, University of Oxford, Oxford, UK (K.H., D.C.); Oxford Cancer and Haematology Centre, Oxford University Hospitals NHS Foundation Trust, Churchill Hospital, Headington, Oxford, UK (D.C.); and Great Ormond Street Hospital NHS Foundation Trust, London, UK (G.A.L.).
David L WinterFrom Centre for Childhood Cancer Survivor Studies, Institute of Applied Health Research, University of Birmingham, Birmingham, UK (M.M.F., R.C.R., K.H., J.K., C.F., D.L.W., M.M.H.); Nuffield Department of Population Health, University of Oxford, Oxford, UK (K.H., D.C.); Oxford Cancer and Haematology Centre, Oxford University Hospitals NHS Foundation Trust, Churchill Hospital, Headington, Oxford, UK (D.C.); and Great Ormond Street Hospital NHS Foundation Trust, London, UK (G.A.L.).
Michael M HawkinsFrom Centre for Childhood Cancer Survivor Studies, Institute of Applied Health Research, University of Birmingham, Birmingham, UK (M.M.F., R.C.R., K.H., J.K., C.F., D.L.W., M.M.H.); Nuffield Department of Population Health, University of Oxford, Oxford, UK (K.H., D.C.); Oxford Cancer and Haematology Centre, Oxford University Hospitals NHS Foundation Trust, Churchill Hospital, Headington, Oxford, UK (D.C.); and Great Ormond Street Hospital NHS Foundation Trust, London, UK (G.A.L.). m.m.hawkins@bham.ac.uk.
British Childhood Cancer Survivor Study (BCCSS) Steering Group

Funding

Cancer Research UK 21133Cancer Research UK A10422Medical Research Council MC_U137686858
6 · The paper itself

Abstract

backgroundIncreased risks of cardiac morbidity and mortality among childhood cancer survivors have been described previously. However, little is known about the very long-term risks of cardiac mortality and whether the risk has decreased among those more recently diagnosed. We investigated the risk of long-term cardiac mortality among survivors within the recently extended British Childhood Cancer Survivor Study.

methodsThe British Childhood Cancer Survivor Study is a population-based cohort of 34 489 five-year survivors of childhood cancer diagnosed from 1940 to 2006 and followed up until February 28, 2014, and is the largest cohort to date to assess late cardiac mortality. Standardized mortality ratios and absolute excess risks were used to quantify cardiac mortality excess risk. Multivariable Poisson regression models were used to evaluate the simultaneous effect of risk factors. Likelihood ratio tests were used to test for heterogeneity and trends.

resultsOverall, 181 cardiac deaths were observed, which was 3.4 times that expected. Survivors were 2.5 times and 5.9 times more at risk of ischemic heart disease and cardiomyopathy/heart failure death, respectively, than expected. Among those >60 years of age, subsequent primary neoplasms, cardiac disease, and other circulatory conditions accounted for 31%, 22%, and 15% of all excess deaths, respectively, providing clear focus for preventive interventions. The risk of both overall cardiac and cardiomyopathy/heart failure mortality was greatest among those diagnosed from 1980 to 1989. Specifically, for cardiomyopathy/heart failure deaths, survivors diagnosed from 1980 to 1989 had 28.9 times the excess number of deaths observed for survivors diagnosed either before 1970 or from 1990 on.

conclusionsExcess cardiac mortality among 5-year survivors of childhood cancer remains increased beyond 50 years of age and has clear messages in terms of prevention strategies. However, the fact that the risk was greatest in those diagnosed from 1980 to 1989 suggests that initiatives to reduce cardiotoxicity among those treated more recently may be having a measurable impact.

Indexed as

AdolescentCardiomyopathiesCardiovascular DiseasesChildChild, PreschoolCohort StudiesFemaleFollow-Up StudiesHeart FailureHumansInfantInfant, NewbornMaleMyocardial IschemiaNeoplasmsRegression Analysismortalityneoplasmspediatrics

Identifiers

PMID28082386
PMCPMC5338891

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.