Adult Survivors of Childhood Cancer

Adult Survivors of Childhood Cancer

They have alarmingly high rates of chronic health conditions.

Most children survive cancer. Although their risk for death from subsequent cancers is high, little else is known about their health status as adults. Investigators compared the health status of 10,397 adults (mean age, 27) who survived childhood cancer with the health status of 3034 cancer-free siblings (mean age, 29). These adult survivors had been treated at 26 oncology centers from 1970 through 1986.

Information about cancer treatment was obtained from the treating institution and from survivors at an average of 17.5 years after cancer diagnosis. Siblings completed a physical health questionnaire. Significantly more survivors than siblings reported a chronic health condition (62.3% vs. 36.8%), and more survivors reported severe or life-threatening chronic health conditions (27.5% vs. 5.2%). Severe health conditions that were significantly more common among survivors included major joint replacement (relative risk, 54), congestive heart failure (RR, 15), second malignancy (RR, 15), cognitive dysfunction (RR, 10), coronary artery disease (RR, 10), cerebrovascular accident (RR, 9), renal failure (RR, 9), hearing loss not corrected by aid (RR, 6), legal blindness (RR, 6), and ovarian failure (RR, 3).

Comment: Although the "war on cancer" in children has been a success in terms of survival, rates of severe health conditions among survivors are staggeringly high. However, as an editorialist notes, the children in this study were treated before 1986, and considerable strides have been made since then in minimizing the adverse effects of treatment protocols.

— Howard Bauchner, MD

Published in Journal Watch Pediatrics and Adolescent Medicine October 25, 2006