19 February 2020

Survivors of cancer developed in adolescence face a six times increased risk of dying before the age of 45 compared to the general population, according to a new analysis.

In addition, 39% of these survivors developed a severe heath condition by the age of 45, according to a study reported for International Childhood Cancer Day last Saturday.

The findings, reported in Lancet Oncology, come from a study of more than 10,000 people who had survived their cancer for at least five years.

Survivors who developed cancer between the ages of 15 and 20, and those diagnosed under the age of 15, were compared with the general population, as well as young adult siblings who did not develop cancer. The survivors had been diagnosed with leukaemia, lymphoma, CNS tumours, neuroblastoma, Wilms tumour, soft-tissue sarcomas and bone cancer, at 27 academic institutions in the USA and Canada.

Although the researchers sought to identify any specific problems faced by adolescents and young adults over the age of 15 following cancer treatment, the study found similar risks of death and ill-health for both age groups of patients.

Of the patients diagnosed younger than age 15, 56% developed a severe health condition by the age of 45. The standardised mortality ratio among the young adult survivors (15-20 year-olds) was 5.9 for deaths from all causes, compared to people from the general population.

Dr Tara Henderson from the University of Chicago, who led the research, said: “Focused efforts are needed to ensure young adult cancer survivors receive long-term health monitoring, with a focus on cancer screening, to reduce their risk of health problems and early death. Studies have shown that adherence to such programmes is poor, so we need to do more to highlight the importance of lifelong care to survivors and their families, as well as primary health care providers.

“We also need further research to understand how best to deliver risk-based care for survivors that incorporates both cancer specialists and primary care providers in the community."

Dr Paivi Lahteenmaki of Turku University in Finland, who was not involved in the research, said: “In the future, identifying underlying genetic or molecular factors that might define patients at high risk of late sequelae would help planning approaches to survivorship.”

Source: Suh E, Stratton KL, Leisenring WM, Nathan PC, Ford JS, Freyer DR, McNeer JL, Stock W, Stovall M, Krull KR, Sklar CA, Neglia JP, Armstrong GT, Oeffinger KC, Robison LL, Henderson TO (2020) “Late mortality and chronic health conditions in long-term survivors of early-adolescent and young adult cancers: a retrospective cohort analysis from the Childhood Cancer Survivor Study”, Lancet Oncology, doi: 10.1016/S1470-2045(19)30800-9


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