Cancer

Childhood Cancer Survivors Face Health Problems Throughout Life

Adult survivors of childhood cancer experience poorer health, more medical illnesses, greater limitations in daily functioning, and decreased productivity compared with adults who did not have cancer as children. Those are the findings of a study published early online in Cancer, a peer-reviewed journal of the American Cancer Society. The results suggest that the effects of childhood cancer are long-lasting and that survivors deserve special attention from the medical community throughout their lives.

The number of adult survivors of childhood cancer in the United States is increasing thanks to effective treatments and improved survival. To determine the burdens that these survivors face throughout their lives, Emily Dowling, MHS, of the National Cancer Institute in Bethesda and her colleagues examined information from individuals who participated in the National Health Interview Survey, which annually collects data on a broad range of health topics through personal household interviews across the United State. A total of 410 adult survivors of childhood cancer and 294,641 individuals without cancer were identified from recent years of the survey. The researchers compared these two groups’ responses to a number of questions related to their health and functional abilities.

Adult survivors of childhood cancer reported poorer outcomes across most general health and productivity measures than individuals without cancer. Survivors were more likely to report their health status as fair or poor (24.3 percent vs 10.9 percent); having any health limitation in any way (12.9 percent vs 3.4 percent); being unable to work due to health problems (20.9 percent vs 6.3 percent); and being limited in the amount or kind of work they could do due to health problems (30.9 percent vs 10.6 percent).

When cancer survivors were categorized by time since diagnosis, they had poor health outcomes in every time interval, with the greatest limitations in the initial four years following diagnosis and 30 or more years after diagnosis. The latter group also experienced the highest level of lost productivity: 46.1 percent were limited in the amount or type of work they could do because of their health problems, and 39.8 percent reported having poor or fair health. In addition, this group of survivors reported missing an average of 69.3 days from work in the past year because of their health problems. The authors say these high levels of burden in this older population of cancer survivors may reflect earlier types of treatment that were administered in the 1970s and 1980s, which have been associated with more health problems than more recent types of cancer treatment.

“Our study suggests that adult survivors of childhood cancer deserve special medical attention and may benefit from interventions to improve their health and productivity,” said Ms. Dowling. She also noted that clinical guidelines currently recommend that cancer survivors receive health care that is based on their risk for additional health conditions.