Chronic health conditions in adult survivors of childhood cancer Journal Article

Authors: Oeffinger, K. C.; Mertens, A. C.; Sklar, C. A.; Kawashima, T.; Hudson, M. M.; Meadows, A. T.; Friedman, D. L.; Marina, N.; Hobbie, W.; Kadan-Lottick, N. S.; Schwartz, C. L.; Leisenring, W.; Robison, L. L.
Article Title: Chronic health conditions in adult survivors of childhood cancer
Abstract: BACKGROUND: Only a few small studies have assessed the long-term morbidity that follows the treatment of childhood cancer. We determined the incidence and severity of chronic health conditions in adult survivors. METHODS: The Childhood Cancer Survivor Study is a retrospective cohort study that tracks the health status of adults who received a diagnosis of childhood cancer between 1970 and 1986 and compares the results with those of siblings. We calculated the frequencies of chronic conditions in 10,397 survivors and 3034 siblings. A severity score (grades 1 through 4, ranging from mild to life-threatening or disabling) was assigned to each condition. Cox proportional-hazards models were used to estimate hazard ratios, reported as relative risks and 95% confidence intervals (CIs), for a chronic condition. RESULTS: Survivors and siblings had mean ages of 26.6 years (range, 18.0 to 48.0) and 29.2 years (range, 18.0 to 56.0), respectively, at the time of the study. Among 10,397 survivors, 62.3% had at least one chronic condition; 27.5% had a severe or life-threatening condition (grade 3 or 4). The adjusted relative risk of a chronic condition in a survivor, as compared with siblings, was 3.3 (95% CI, 3.0 to 3.5); for a severe or life-threatening condition, the risk was 8.2 (95% CI, 6.9 to 9.7). Among survivors, the cumulative incidence of a chronic health condition reached 73.4% (95% CI, 69.0 to 77.9) 30 years after the cancer diagnosis, with a cumulative incidence of 42.4% (95% CI, 33.7 to 51.2) for severe, disabling, or life-threatening conditions or death due to a chronic condition. CONCLUSIONS: Survivors of childhood cancer have a high rate of illness owing to chronic health conditions. Copyright © 2006 Massachusetts Medical Society.
Keywords: adolescent; adult; cancer survival; child; controlled study; middle aged; leukemia; bone tumor; retrospective studies; mortality; cancer risk; outcome assessment; antineoplastic agent; cancer diagnosis; neoplasms; cohort studies; proportional hazards models; incidence; morbidity; prevalence; alkylating agent; cancer therapy; central nervous system tumor; childhood cancer; hodgkin disease; cancer survivor; risk; siblings; survivors; sarcoma; chronic disease; disease severity; nonhodgkin lymphoma; health status; neuroblastoma; anthracycline; nephroblastoma
Journal Title: New England Journal of Medicine
Volume: 355
Issue: 15
ISSN: 0028-4793
Publisher: Massachusetts Medical Society  
Date Published: 2006-10-12
Start Page: 1572
End Page: 1582
Language: English
DOI: 10.1056/NEJMsa060185
PUBMED: 17035650
PROVIDER: scopus
Notes: --- - "Cited By (since 1996): 525" - "Export Date: 4 June 2012" - "CODEN: NEJMA" - "Source: Scopus"
Citation Impact
MSK Authors
  1. Charles A Sklar
    299 Sklar
  2. Kevin Oeffinger
    280 Oeffinger