Survivors of early onset solid cancers face high late mortality risks, significantly affecting surgical outcomes.

• At 40 years post-diagnosis, cumulative all-cause mortality is 50%.
• Survivors have an all-cause mortality rate 77% higher than the general population.
• Non-cancer health-related causes eventually lead to more deaths than cancer progression.

Surgeons should be aware of these long-term risks when planning follow-up care and patient support.

• Distinct survivor groups reveal 13 cancers with increased mortality and 6 with lower mortality relative to the general population.