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Childhood cancer survivors at greater risk for chronic health conditions
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Gregory T. Armstrong
Middle-aged childhood cancer survivors were at increased risk for a number of chronic health conditions, ranging from myocardial infarction to joint replacement, compared with their healthy siblings, according to study results.
Gregory T. Armstrong, MD, of St. Jude Children’s Research Hospital in Memphis, Tenn., said the aim of the study was to define incidence and magnitude of risk for chronic health conditions in cancer survivors compared with siblings.
“We wanted to identify specific health conditions that increase in incidence as survivors age though middle adulthood,” he said.
There were 14,358 childhood cancer survivors and 4,031 siblings evaluated in the analysis.
Eligible participants had survived for more than 5 years. The median age at last follow-up was 32.3 years, with a range of 8 to 58 years; 21.4% of survivors were aged older than 40 years.
The researchers analyzed for two primary outcome measures: severe/life-threatening/fatal conditions (grades 3-5), and multiple (>2) conditions.
“One in five healthy survivors have had a severe, life-threatening event or death within 10 years by age 45, compared with one in 14 healthy siblings,” Armstrong said.
Survivors older than age 35 years were at a significantly increased risk for several specific conditions compared with siblings, including:
- Congestive heart failure (HR=10.9; 95% CI, 4.6-26.3)
- Myocardial infarction (HR=5.1; 95% CI, 3.1-8.4)
- Stroke (HR=6.6; 95% CI, 3.1-14.1)
- Joint replacement (HR=2.2; 95% CI, 1.0-4.6)
- Renal failure (HR=6.0; 95% CI, 0.6-47.7)
“Through middle adulthood, survivors have increasing risk for severe and life-threatening outcomes, multiple outcomes, even when healthy to age 45,” Armstrong concluded. “Twenty-year-old survivors and 50-year-old siblings had equivalent incidence rates of severe or life-threatening events.”
Armstrong said this may be due to premature aging and frailty.
“These data highlight the necessity of monitoring health risks with continued aging among childhood cancer survivors,” he said.
Reference:
- Armstrong GA. Abstract #9514.
Disclosure:
- Dr. Armstrong reports no relevant financial disclosures.