4-5 minutes
Survivors of childhood cancer are at increased risk for severe health
problems later in life compared to the general population, according to a
study published Friday in The Lancet Oncology.
The analysis found that more than one in three people diagnosed during
adolescence or early adulthood develop a serious, life-threatening
health condition when they get older.
The study focused on people diagnosed with cancer between 1970 and 1999,
so it's not clear whether adolescents and young adults diagnosed today
can expect similar outcomes, particularly given that more effective
treatments have become available.
"While previous studies have examined long-term outcomes for people who
survive five years or more after cancer diagnosis in childhood or
adulthood, our study is the first to specifically investigate health
consequences for those diagnosed in adolescence and young adulthood,"
co-author Eugene Suh, a pediatric oncologist Loyola University Chicago
Health Sciences, said in a press release. "These survivors have the
potential to live long, healthy lives but they remain at risk of health
problems as a consequence of their previous cancer treatments."
The findings echo those of research published in August 2019 in the
journal Circulation, which noted that child cancer survivors are 10
times more likely to develop heart failure than children without cancer.
For their research, Suh and his colleagues reviewed data from the
Childhood Cancer Survivor Study, which has been tracking the health of
more than 24,000 people across the United States who were diagnosed with
cancer between 1970 and 1999 and survived for five or more years
following diagnosis.
They focused specifically on 5,804 cancer survivors between 15 and 21
years of age at the time of their initial cancer diagnosis, and randomly
selected 5,804 people who were diagnosed with cancer when they were 15
years old or younger for comparison.
Finally, they recruited a third group of 5,059 siblings of similar ages
to serve as controls. These participants had no history of childhood
cancer.
The researchers tracked the death rates and causes of death for each of
the three groups and reviewed medical records for recurrences of cancer
and severe health problems associated with the heart, lungs, and
musculoskeletal systems, as well as metabolic and neurological
conditions.
Based on their analysis, they estimated that the likelihood of a young
adult cancer survivor developing a severe health condition by age 45 was
39 percent versus 12 percent for cancer-free siblings of the same age.
The risks for people diagnosed as adolescents were lower than those of
childhood cancer survivors diagnosed before age 15, for which the
likelihood of developing a severe condition by age 45 was 56 percent.
The risk of mortality from any cause among young adult survivors was
almost six times higher than in the general population. Early adolescent
and young adult cancer survivors were nearly twice as likely to die
from recurrence or progression of their primary cancer compared with
childhood cancer survivors.
In general, the differences in health outcomes between childhood
survivors and young adults were most notable 20 years after diagnosis,
the authors added, suggesting that their findings underscore the
importance of long-term health screening for child and young adult
cancer survivors.
"Focused efforts are needed to ensure young adult cancer survivors
receive long-term health monitoring, with a focus on cancer screening,
to reduce their risk of health problems and early death," said co-author
Tara Henderson, associate professor of pediatrics at the University of
Chicago. "Studies have shown that adherence to such programs is poor, so
we need to do more to highlight the importance of lifelong care to
survivors and their families, as well as primary health care providers."
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