The research, led by Dr. Po Hu from the Department of Pulmonary Diseases, Changzhou Hospital of Traditional Chinese Medicine, Jiangsu, China, and colleagues, emphasizes the need for long-term respiratory monitoring and preventive care in this growing survivor group.
The study analyzed data from the Surveillance, Epidemiology, and End Results (SEER) 8 database, covering cancer cases diagnosed between 1975 and 2021. It focused on 125,051 individuals who had survived at least five years after being diagnosed with cancer between the ages of 15 and 39 years. Researchers assessed their long-term mortality due to major respiratory diseases, including pneumonia and chronic lower respiratory disease, and compared it to that of the general U.S. population.
The key findings of the study were as follows:
- Five-year survivors of adolescent and young adult (AYA) cancers had a 1.1-fold higher risk of major respiratory mortality compared to the general population.
- This increased risk corresponds to 0.25 excess deaths per 10,000 person-years.
- Hodgkin’s lymphoma survivors had the highest mortality from pneumonia.
- Lung cancer survivors showed the greatest risk of death from chronic lower respiratory diseases.
- Male survivors experienced nearly twice the pneumonia-related mortality compared to female survivors (0.7 versus 0.3 per 10,000 person-years).
- Black survivors had a 54% higher risk of chronic lower respiratory disease–related deaths compared to other racial groups.
The researchers attributed these findings to a combination of factors, including prior cancer treatments such as chest radiation, chemotherapy-induced lung toxicity, and long-term immune suppression. They also pointed out that behavioral and socioeconomic factors, such as smoking habits and healthcare access, might contribute to these disparities.
Dr. Hu and colleagues highlighted that the risk of respiratory-related deaths varied significantly depending on the cancer type, age, sex, and ethnicity of survivors. This variation underscores the importance of tailored follow-up strategies for different survivor subgroups. They recommended that clinicians incorporate routine pulmonary function assessments, vaccination against respiratory infections, and counseling for smoking cessation and lifestyle modification into survivorship care plans.
The study further noted that as advances in cancer therapy continue to improve survival rates among young patients, the number of long-term survivors is expected to rise, making chronic health complications like respiratory diseases an increasing concern.
The authors concluded that their findings emphasize the need for personalized long-term care guidelines focused on respiratory health for AYA cancer survivors. By recognizing and addressing risk heterogeneity across demographic and clinical factors, healthcare providers can better safeguard this vulnerable population against late-onset respiratory complications.
Reference:
Hu, P., Zhu, W., Chen, Y., Mei, W., & Wang, L. (2025). Long-term major respiratory mortality among 5-year survivors of adolescent and young adult cancer. CHEST. https://doi.org/10.1016/j.chest.2025.10.007
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