Infections among long-term survivors of childhood and adolescent cancer: A report from the Childhood Cancer Survivor Study Journal Article

Authors: Perkins, J. L.; Chen, Y.; Harris, A.; Diller, L.; Stovall, M.; Armstrong, G. T.; Yasui, Y.; Robison, L. L.; Sklar, C. A.
Article Title: Infections among long-term survivors of childhood and adolescent cancer: A report from the Childhood Cancer Survivor Study
Abstract: BACKGROUND Little is known about infections among adult survivors of childhood cancer. The authors report the occurrence of infections and risk factors for infections in a large cohort of survivors of childhood cancer. METHODS The Childhood Cancer Survivor Study cohort was used to compare incidence rates of infections among 12,360 5-year survivors of childhood cancer with the rates of 4023 siblings. Infection-related mortality of survivors was compared with that of the US population. Demographic and treatment variables were analyzed using Poisson regression to determine the rate ratios (RRs) and corresponding 95% confidence intervals (CIs) for associations with infectious complications. RESULTS Compared with the US population, survivors were at an increased risk of death from infectious causes (standardized mortality ratio [SMR], 4.2; 95% CI, 3.2-5.4), with the greatest risk observed among females (SMR, 3.2; 95% CI, 1.5-6.9) and among those who had been exposed to total body irradiation (SMR, 7.8; 95% CI, 1.8-33.0). Survivors also reported higher rates than siblings of overall infectious complications (RR, 1.3; 95% CI, 1.2-1.4) and higher rates of all categories of infection. CONCLUSIONS Survivors of childhood cancer remain at elevated risk for developing infectious-related complications, and they have a higher risk of infection-related mortality years after therapy. Further investigation is needed to provide insight into the mechanisms for the observed excess risks. © 2014 American Cancer Society.
Keywords: adolescent; adult; child; major clinical study; mortality; infection; childhood cancer; hodgkin disease; late effects; cancer survivor; nonhodgkin lymphoma; whole body radiation; survivorship; sex difference; lung infection; infection risk; infectious complication; adolescent cancer; gastrointestinal infection; sinusitis; infection rate; infections; human; male; female; priority journal; article; standardized mortality ratio
Journal Title: Cancer
Volume: 120
Issue: 16
ISSN: 0008-543X
Publisher: Wiley Blackwell  
Date Published: 2014-08-15
Start Page: 2514
End Page: 2521
Language: English
DOI: 10.1002/cncr.28763
PROVIDER: scopus
PUBMED: 24824782
PMCID: PMC4159255
Notes: Export Date: 2 September 2014 -- CODEN: CANCA -- Source: Scopus
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MSK Authors
  1. Charles A Sklar
    299 Sklar