Excess mortality in young cancer survivors compared with the general population in Italy: a retrospective study from the Italian population-based cohort of adolescents and young adult cancer survivors.

Background: Adolescents and young adults (AYA) cancer survivors experience increased morbidity and mortality from second cancers, cardiovascular, infectious, kidney, and other chronic diseases. We aim to calculate all-causes cancer and non-cancer excess mortality of young cancer survivors compared to the general population. Methods: The AYA cohort includes cancer patients diagnosed between 1976 and 2013 and alive at 5 years after diagnosis in 30 population-based Cancer Registries and followed up until 31 December 2019. The standardised mortality ratios (SMRs) and absolute excess risks (AERs) per 100,000 for person-years were calculated. Results: 58,387 5-year survivors were followed up for 427,130 person-years; the median follow-up time was 5.7 years beyond the 5 Conclusions: The excess mortality is mostly due to the malignancy of the primary tumour, but an about 2-fold excess of mortality is also appreciable for non-cancer causes. Young adult cancer survivors face a sevenfold increase in all-cause mortality compared to the general population, with a notable rise in both cancer-related and non-cancer deaths. Thirty years post-diagnosis, the excess risk from cancer and non-cancer causes becomes nearly equal.