This article is more than 5 years old. Information may no longer be current.
Pediatric cancer survivors at increased risk for mortality, morbidity after age 35
Click Here to Manage Email Alerts
Adult survivors of childhood cancers demonstrated a fivefold higher risk than their siblings for developing new cancers or other life-threatening conditions after the age of 35 years, according to results of a multi-institutional, retrospective cohort study.
Researchers conducted long-term follow-up on 14,359 childhood cancer survivors treated at 26 hospitals in the United States and Canada. A comparison group consisting of a random sampling of participants’ siblings (n=4,031) also was included for analysis.
Study participants completed a multi-item survey at baseline and at each follow-up during a median of 24.5 years after diagnosis (range, 5-39.3 years). The surveys gleaned information about the patients’ organ-based medical conditions, and the researchers applied a severity score using the Common Terminology Criteria for Adverse Events (grades 3 to 5).
Information about cancer diagnoses and treatment was obtained from medical records. The researchers used Cox proportional hazards models to compare severe, disabling or fatal medical conditions in survivors vs. siblings.
At the last follow-up, 5,604 of the survivors were aged at least 35 years (range, 35-62 years).
Data showed the cancer survivors had a higher aggregate incidence of a severe, disabling, life-threatening or fatal health condition than their siblings (53% vs. 19.8%) by the age of 50 years.
In comparisons of survivors to their siblings, HRs were significantly elevated within the age group of 5 to 19 years (HR=6.8; 95% CI, 5.5-8.3), the age group of 20 to 34 years (HR=3.8; 95% CI, 3.2-4.5) and the 35 years and older age group (HR=5; 95% CI, 4.1-6.1). The HR was significantly higher in those 35 years and older vs. those who were 20 to 34 years (P=.03).
Gregory Armstrong
Of the cancer survivors who reached the age of 35 years without a previous grade 3 or grade 4 condition, 25.9% developed a grade 3 to 5 condition within the ensuing 10 years vs. 6% of siblings (P<.001). By age 50 years, more than half of the cancer survivors had experienced a severe or disabling event, including death.
“Survivors remain at risk for serious health problems into their 40s and 50s, decades after they have completed treatment for childhood cancer,” Gregory Armstrong, MD, an associate member of the department of epidemiology and cancer control at St. Jude Children’s Research Hospital in Memphis, Tenn., said in a press 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.”
Disclosure: The researchers report no relevant financial disclosures.
Click Here to Manage Email Alerts