Cancer burden among adolescents and young adults in relation to childhood adversity: a nationwide life-course cohort study of 1.2 million individuals

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Cancer burden among adolescents and young adults in relation to childhood adversity : a nationwide life-course cohort study of 1.2 million individuals. / Rod, Naja Hulvej; Bengtsson, Jessica; Elsenburg, Leonie K.; Davies, Megan; Taylor-Robinson, David; Bhatt, Samir; Rieckmann, Andreas.

I: The Lancet Regional Health - Europe, Bind 27, 2023.

Publikation: Bidrag til tidsskriftTidsskriftartikelfagfællebedømt

Harvard

Rod, NH, Bengtsson, J, Elsenburg, LK, Davies, M, Taylor-Robinson, D, Bhatt, S & Rieckmann, A 2023, 'Cancer burden among adolescents and young adults in relation to childhood adversity: a nationwide life-course cohort study of 1.2 million individuals', The Lancet Regional Health - Europe, bind 27. https://doi.org/10.1016/j.lanepe.2023.100588

APA

Rod, N. H., Bengtsson, J., Elsenburg, L. K., Davies, M., Taylor-Robinson, D., Bhatt, S., & Rieckmann, A. (2023). Cancer burden among adolescents and young adults in relation to childhood adversity: a nationwide life-course cohort study of 1.2 million individuals. The Lancet Regional Health - Europe, 27. https://doi.org/10.1016/j.lanepe.2023.100588

Vancouver

Rod NH, Bengtsson J, Elsenburg LK, Davies M, Taylor-Robinson D, Bhatt S o.a. Cancer burden among adolescents and young adults in relation to childhood adversity: a nationwide life-course cohort study of 1.2 million individuals. The Lancet Regional Health - Europe. 2023;27. https://doi.org/10.1016/j.lanepe.2023.100588

Author

Rod, Naja Hulvej ; Bengtsson, Jessica ; Elsenburg, Leonie K. ; Davies, Megan ; Taylor-Robinson, David ; Bhatt, Samir ; Rieckmann, Andreas. / Cancer burden among adolescents and young adults in relation to childhood adversity : a nationwide life-course cohort study of 1.2 million individuals. I: The Lancet Regional Health - Europe. 2023 ; Bind 27.

Bibtex

@article{aea9cf2c8009433eab7867ca6c3f74d6,
title = "Cancer burden among adolescents and young adults in relation to childhood adversity: a nationwide life-course cohort study of 1.2 million individuals",
abstract = "Background: Childhood adversity such as poverty, loss of a parent, and dysfunctional family dynamics may be associated with exposure to environmental and behavioral hazards, interfere with normal biological functions, and affect cancer care and outcomes. To explore this hypothesis, we assessed the cancer burden among young men and women exposed to adversity during childhood. Methods: We undertook a population-based study using Danish nationwide register data on childhood adversity and cancer outcomes. Children who were alive and resident in Denmark until their 16th birthday were followed into young adulthood (16–38 years). Group-based multi-trajectory modelling was used to categorize individuals into five distinct groups: low adversity, early material deprivation, persistent material deprivation, loss/threat of loss, and high adversity. We assessed the association with overall cancer incidence, mortality, and five-year case fatality; and cancer specific outcomes for the four most common cancers in this age group in sex-stratified survival analyses. Findings: 1,281,334 individuals born between Jan 1, 1980, and Dec 31, 2001, were followed up until Dec 31, 2018, capturing 8229 incident cancer cases and 662 cancer deaths. Compared to low adversity, women who experienced persistent material deprivation carried a slightly lower risk of overall cancer (hazard ratio (HR) 0.90; 95% CI 0.82; 0.99), particularly due to malignant melanoma and brain and central nervous system cancers, while women who experienced high adversity carried a higher risk of breast cancer (HR 1.71; 95% CI 1.09; 2.70) and cervical cancer incidence (HR 1.82; 95% CI 1.18; 2.83). While there was no clear association between childhood adversity and cancer incidence in men, those men who had experienced persistent material deprivation (HR 1.72; 95% CI 1.29; 2.31) or high adversity (HR 2.27; 95% CI 1.38; 3.72) carried a disproportionate burden of cancer mortality during adolescence or young adulthood compared to men in the low adversity group. Interpretation: Childhood adversity is associated with a lower risk of some subtypes of cancer and a higher risk of others, particular in women. Persistent deprivation and adversity are also associated with a higher risk of adverse cancer outcomes for men. These findings may relate to a combination of biological susceptibility, health behaviors and treatment-related factors. Funding: None.",
keywords = "Cancer case fatality, Cancer incidence, Cancer mortality, Childhood adversity, Health inequality",
author = "Rod, {Naja Hulvej} and Jessica Bengtsson and Elsenburg, {Leonie K.} and Megan Davies and David Taylor-Robinson and Samir Bhatt and Andreas Rieckmann",
year = "2023",
doi = "10.1016/j.lanepe.2023.100588",
language = "English",
volume = "27",
journal = "The Lancet Regional Health - Europe",
issn = "2666-7762",
publisher = "Elsevier",

}

RIS

TY - JOUR

T1 - Cancer burden among adolescents and young adults in relation to childhood adversity

T2 - a nationwide life-course cohort study of 1.2 million individuals

AU - Rod, Naja Hulvej

AU - Bengtsson, Jessica

AU - Elsenburg, Leonie K.

AU - Davies, Megan

AU - Taylor-Robinson, David

AU - Bhatt, Samir

AU - Rieckmann, Andreas

PY - 2023

Y1 - 2023

N2 - Background: Childhood adversity such as poverty, loss of a parent, and dysfunctional family dynamics may be associated with exposure to environmental and behavioral hazards, interfere with normal biological functions, and affect cancer care and outcomes. To explore this hypothesis, we assessed the cancer burden among young men and women exposed to adversity during childhood. Methods: We undertook a population-based study using Danish nationwide register data on childhood adversity and cancer outcomes. Children who were alive and resident in Denmark until their 16th birthday were followed into young adulthood (16–38 years). Group-based multi-trajectory modelling was used to categorize individuals into five distinct groups: low adversity, early material deprivation, persistent material deprivation, loss/threat of loss, and high adversity. We assessed the association with overall cancer incidence, mortality, and five-year case fatality; and cancer specific outcomes for the four most common cancers in this age group in sex-stratified survival analyses. Findings: 1,281,334 individuals born between Jan 1, 1980, and Dec 31, 2001, were followed up until Dec 31, 2018, capturing 8229 incident cancer cases and 662 cancer deaths. Compared to low adversity, women who experienced persistent material deprivation carried a slightly lower risk of overall cancer (hazard ratio (HR) 0.90; 95% CI 0.82; 0.99), particularly due to malignant melanoma and brain and central nervous system cancers, while women who experienced high adversity carried a higher risk of breast cancer (HR 1.71; 95% CI 1.09; 2.70) and cervical cancer incidence (HR 1.82; 95% CI 1.18; 2.83). While there was no clear association between childhood adversity and cancer incidence in men, those men who had experienced persistent material deprivation (HR 1.72; 95% CI 1.29; 2.31) or high adversity (HR 2.27; 95% CI 1.38; 3.72) carried a disproportionate burden of cancer mortality during adolescence or young adulthood compared to men in the low adversity group. Interpretation: Childhood adversity is associated with a lower risk of some subtypes of cancer and a higher risk of others, particular in women. Persistent deprivation and adversity are also associated with a higher risk of adverse cancer outcomes for men. These findings may relate to a combination of biological susceptibility, health behaviors and treatment-related factors. Funding: None.

AB - Background: Childhood adversity such as poverty, loss of a parent, and dysfunctional family dynamics may be associated with exposure to environmental and behavioral hazards, interfere with normal biological functions, and affect cancer care and outcomes. To explore this hypothesis, we assessed the cancer burden among young men and women exposed to adversity during childhood. Methods: We undertook a population-based study using Danish nationwide register data on childhood adversity and cancer outcomes. Children who were alive and resident in Denmark until their 16th birthday were followed into young adulthood (16–38 years). Group-based multi-trajectory modelling was used to categorize individuals into five distinct groups: low adversity, early material deprivation, persistent material deprivation, loss/threat of loss, and high adversity. We assessed the association with overall cancer incidence, mortality, and five-year case fatality; and cancer specific outcomes for the four most common cancers in this age group in sex-stratified survival analyses. Findings: 1,281,334 individuals born between Jan 1, 1980, and Dec 31, 2001, were followed up until Dec 31, 2018, capturing 8229 incident cancer cases and 662 cancer deaths. Compared to low adversity, women who experienced persistent material deprivation carried a slightly lower risk of overall cancer (hazard ratio (HR) 0.90; 95% CI 0.82; 0.99), particularly due to malignant melanoma and brain and central nervous system cancers, while women who experienced high adversity carried a higher risk of breast cancer (HR 1.71; 95% CI 1.09; 2.70) and cervical cancer incidence (HR 1.82; 95% CI 1.18; 2.83). While there was no clear association between childhood adversity and cancer incidence in men, those men who had experienced persistent material deprivation (HR 1.72; 95% CI 1.29; 2.31) or high adversity (HR 2.27; 95% CI 1.38; 3.72) carried a disproportionate burden of cancer mortality during adolescence or young adulthood compared to men in the low adversity group. Interpretation: Childhood adversity is associated with a lower risk of some subtypes of cancer and a higher risk of others, particular in women. Persistent deprivation and adversity are also associated with a higher risk of adverse cancer outcomes for men. These findings may relate to a combination of biological susceptibility, health behaviors and treatment-related factors. Funding: None.

KW - Cancer case fatality

KW - Cancer incidence

KW - Cancer mortality

KW - Childhood adversity

KW - Health inequality

U2 - 10.1016/j.lanepe.2023.100588

DO - 10.1016/j.lanepe.2023.100588

M3 - Journal article

C2 - 36843914

VL - 27

JO - The Lancet Regional Health - Europe

JF - The Lancet Regional Health - Europe

SN - 2666-7762

ER -

ID: 340530479