Overall and Cause-Specific Late Mortality in Long-Term Survivors of Early Onset Solid Cancer After Surgery: A Population-Based Retrospective Cohort Study.

Authors

Jian Li, Xiaohong Kuang

Published in

Annals of surgical oncology. Aug 13, 2026. Epub Aug 13, 2026.

Abstract

Late mortality of early onset solid cancer survivors remains poorly characterized. We quantified the late mortality among 5-year survivors of early onset solid cancers following surgery.
This retrospective cohort study analyzed data from the Surveillance, Epidemiology, and End Results (SEER) database, including 5-year survivors of solid cancer at age 20-49 years following surgery during 1975-2017. We estimated the cumulative mortality probabilities, standardized mortality ratios (SMRs), and absolute excess risks (AERs) for all-cause and cause-specific mortality compared with the general population.
A total of 294,994 survivors (median age 42 years, IQR 35-46 years) were included, with median follow-up of 17.8 years (IQR 10.7-26.8 years). At 40 years post-diagnosis, cumulative all-cause mortality reached 50.0% (95% CI 49.6-50.4%). While recurrence or progression dominated mortality initially, non-cancer health-related causes ultimately became the leading contributor to death. Overall, survivors exhibited significantly elevated all-cause mortality compared with the general population (SMR 1.77, 95% CI 1.76-1.79). On the basis of non-cancer health-related mortality, two distinct survivor groups emerged: 13 cancers with increased mortality (SMR 1.41, 95% CI 1.38-1.44) and 6 cancers with decreased mortality (SMR 0.78, 95% CI 0.77-0.80) relative to the general population.
Long-term early onset solid cancer survivors after surgery face substantial late mortality burden, with non-cancer health-related causes ultimately surpassing recurrence or progression as the leading cause of death. On the basis of non-cancer health-related mortality, increased-risk and decreased-risk cancer types can be distinguished.

PMID:
42595943
Bibliographic data and abstract were imported from PubMed on 14 Aug 2026.

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