A new study shows that adult survivors of childhood cancer are at significantly greater risk for health problems as they age, and are five times more likely than their siblings to have health problems after age 35.
Adult survivors of childhood cancer require long-term health monitoring for the rest of their lives. This message comes from St. Jude
Children’s Research Hospital, in the wake of recent findings from the
Childhood Cancer Survivor Study (CCSS).
The study, which was published in the Journal of Clinical Oncology,
found that adult survivors of childhood cancer face significant health
problems as they grow older. What’s more, they are five times more
likely than their siblings to develop new cancers, heart problems, and other
serious health conditions after age 35.
The oldest survivors in
this study were in their 50s. The CCSS study also found that the health
gap between survivors and their siblings widens with age. Survivors who
were 20 to 34 years old were 3.8 times more likely than siblings of the
same age to have experienced severe, disabling, life-threatening, or
fatal health conditions. By age 35 and beyond, however, survivors were
at five-fold greater risk.
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At 50, Life-Changing Health Problems
the time they reach 50 years of age, more than half of childhood cancer
survivors had experienced a life-changing health problem, versus less
than one-fifth of siblings that were the same age.
More than 22
percent of survivors had at least two serious health problems, while
about 10 percent mentioned that they had three or more serious health
problems. New cancers and diseases of the heart, lungs, liver, kidneys, and
hormones were reported.
There are now more than 363,000 pediatric
cancer survivors in the U.S. An overall long-term pediatric cancer
survival rate of 80 percent means the number of survivors will increase,
according to St. Jude.
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Siblings Don’t Share Same Health Risks
Armstrong, M.D., an associate member of the St. Jude Department of
Epidemiology and Cancer Control and the lead author of the CCSS study,
issued a statement advising that survivors remain at risk
for serious health problems into their 40s and 50s, decades after they
have completed treatment for childhood cancer. “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,” said Armstrong.
In survivors who celebrated their 35th birthday without serious health problems, 25.9 percent had a
significant health problem in the next decade, compared with 6 percent of
siblings. The siblings developed their first serious health problem
between 35 and 45 years of age.
The study evaluated 14,359 adult
survivors who were treated for a variety of pediatric cancers at one of
26 U.S. and Canadian medical centers, with a focus on 5,604 survivors
who are now over 35 years of age. In addition, 4,301 siblings were
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Lifelong Follow-Up Is Essential
findings underscore the necessity of lifelong, risk-based health care
for cancer survivors, according to Armstrong. Depending on their cancer
treatment and other risk factors, Armstrong suggested that mammograms
and other health checks be conducted at a younger age than is
recommended for the general public as part of follow-up care.
screenings are designed to identify health problems at an early stage
when there is a greater chance to prevent illness and preserve health.
St. Jude researchers are also looking at methods to educate and empower
survivors so that they get the screenings.
The CCSS study and
other survivorship studies, including those by St. Jude, lend credence
to the idea that accelerated aging is a possible explanation for why
some childhood cancer survivors develop chronic health problems decades
earlier than their siblings.
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