Mortality after childhood cancer

Background: Despite improved cure rates, childhood cancer remains the most common disease related cause of death in childhood. In the first 10 years after diagnosis the primary cancer is the main cause of death, but thereafter deaths from second primary cancers and chronic diseases predominate.

Objectives: This project aims to: 1) analyse survival and factors associated with survival after cancer in childhood; 2) analyse total and cause-specific mortality, including late mortality (>5 years after diagnosis of cancer) after cancer in childhood.

Methods: This study uses data from all children diagnosed with cancer in Switzerland. Vital status and date of death are updated via municipal population registries. Cause of death is available from the Swiss mortality statistics. We estimate survival at 5, 10 and 20 years after diagnosis, overall and stratified by diagnosis, and analyse time trends in survival. We examine determinants of survival (sex, type of childhood cancer, tumour histology, age at diagnosis, treatment modalities, region of residence, socio-economic position). For aim 2 we calculate overall and cause-specific standardized morality ratios (SMR) and absolute excess risks (AER), cumulative mortality and risk factors for specific causes of death.

Rationale and significance: This project provides the first national data on survival and long-term mortality after cancer in childhood in Switzerland. Knowledge about avoidable risk factors for premature death will help to develop improved treatments.

Current status of project:  Analysis is ongoing and 2 publications are being written.

Study team: Kuehni CE, Schindler M, Institute of Social and Preventive Medicine University of Bern; Michel G, Department of Health Sciences and Health Policy, University of Lucerne

Funding: Swiss National Science Foundation (PDFMP3_141775), Swiss Bridge

Contact: Claudia Kuehni (, Matthias Schindler (

© ISPM - University of Bern 2016