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Study examines health problems of childhood cancer survivors

Friday April 11, 2014
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Adult survivors of childhood cancer face significant health problems as they age and are five times more likely than their siblings to develop new cancers and heart and other serious health conditions beyond age 35, according to the latest findings from the world's largest study of childhood cancer survivors.

The federally funded Childhood Cancer Survivor Study found that the health gap between survivors and their siblings widens with age. Survivors who were ages 20 to 34 were 3.8 times more likely than siblings of the same age to have experienced severe, disabling, life-threatening or fatal health conditions.

By age 35 and beyond, survivors were at five-fold greater risk, researchers at St. Jude Children’s Research Hospital in Memphis, Tenn., and other facilities reported on the website of the Journal of Clinical Oncology.

By age 50, more than half of childhood cancer survivors had experienced a life-altering health problem, compared with less than 20% of same-aged siblings. More than 22% of survivors had at least two serious health problems and about 10% reported three or more. The problems included new cancers and diseases of the heart, lungs, liver, kidneys and hormones.

“Survivors remain at risk for serious health problems into their 40s and 50s, decades after they have completed treatment for childhood cancer,” first and corresponding author Gregory Armstrong, MD, an associate member of the St. Jude Department of Epidemiology and Cancer Control, said in a news release.

“In fact, for survivors, the risk of illness and death increases significantly beyond the age of 35. Their siblings don't share these same risks.”

Among survivors who reached age 35 without serious health problems, 25.9% developed a significant health problem in the next decade. In comparison, 6% of siblings developed their first serious health condition between ages 35 and 45.

The study involved 14,359 adult survivors who were treated for a variety of pediatric cancers at one of 26 U.S. and Canadian medical centers, and 4,301 siblings. For this study CCSS investigators focused on 5,604 survivors who have aged beyond 35. The results provide the broadest snapshot yet of how the first generation of childhood cancer survivors is faring as they age, according to the news release. The oldest survivors in this study were in their 50s.

The findings highlight the importance of lifelong, risk-based healthcare for childhood cancer survivors, Armstrong said. Depending on their cancer treatment and other risk factors, follow-up care may include mammograms and other health checks at a younger age than is recommended for the general public.

Study abstract: http://jco.ascopubs.org/content/early/2014/03/14/JCO.2013.51.1055.abstract


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