Survival rates for children, adolescents and young adults with cancer have improved substantially in recent years. But survivors still face a much higher risk of death and severe chronic health conditions as they approach middle age, Healio reports. That’s especially true for people who get cancer in their late teens or early 20s.
Eugene Suh, MD, an assistant professor of pediatric hematology and oncology at Loyola University Medical Center, and colleagues analyzed data from the Childhood Cancer Survivor Study, which tracked the health outcomes of people who survived for five years beyond a diagnosis of cancer they received before their 21st birthday and between 1970 and 1999.
The study authors, who published their findings in The Lancet Oncology, looked at the health outcomes of 5,804 cancer survivors diagnosed between ages 15 and 20 as well as 5,804 survivors diagnosed before age 15 who had the same primary cancer. (A primary cancer is the original malignancy, before it may have spread elsewhere.) They compared these groups with a group of their siblings of similar age.
This was the first study to examine long-term health outcomes among people who survive at least five years after cancer diagnosed during adolescence or young adulthood. Previous studies have conducted such analyses regarding those diagnosed with cancer during childhood or adulthood.
In the new study, the survivors of cancers diagnosed during adolescence and young adulthood were followed for a median of 20.6 years and had a median age of 42 years old, while the survivors of childhood cancer were followed for a median of 21.1 years and had a median age of 34 years old.
During the study’s follow-up period, compared with individuals of the same age and sex in the general population, the early-adolescent and young-adult cancer survivors were 5.9 times more likely to die from any cause, and the childhood cancer survivors were 6.2 times more likely to die of any cause.
During follow-up, compared with survivors of childhood cancer, survivors of early-adolescent and young-adult cancer were less likely to die, specifically of causes not related to recurrence or progression of their primary cancer. This disparity was especially apparent 20 years after their respective cancer diagnoses.
That said, survivors of cancer diagnosed between ages 15 and 20 were 60% more likely to die due to recurrence or progression of their primary cancer compared with those diagnosed with cancer at younger ages. In other words, those whose cancer first occurred in adolescence or early adulthood were even more likely to experience a recurrence than those whose cancer first occurred during childhood.
Many survivors experienced other serious health conditions as well. Compared with their siblings of a similar age, those who survived childhood cancer and those who survived early-adolescent and young-adult cancer were a respective 5.6 times and 4.2 times more likely to develop severe, disabling, life-threatening or fatal health conditions, including cardiac, endocrine and musculoskeletal conditions. Meanwhile, as Healio reports in a separate article, survivors of childhood cancer may experience premature aging.
The authors recommend better monitoring of survivors to improve early cancer detection. “Focused efforts are needed to ensure young adult [survivors of cancer] receive long-term health monitoring, with a focus on cancer screening, to reduce their risk for health problems and early death,” said Tara Henderson, MD, associate professor of pediatrics and director of the Childhood Cancer Survivors Center at University of Chicago, Healio.
For more articles in Cancer Health in childhood cancer, click here.
To read the Healio article on survival rates, click here.
To read the study abstract, click here.
To read the Healio article on premature aging, click here.