Most Childhood Cancer Survivors Have at Least One Chronic Health Condition

Siobhan M. Phillips, PhD, MPH

A new study has found that although the number of childhood cancer survivors is increasing, the majority of those to survive 5 or more years beyond diagnosis have at least one chronic health condition.

The study, published in Cancer Epidemiology, Biomarkers & Prevention, found that the number of childhood cancer survivors increased by nearly 60,000 from a previous estimate in 2005 and that 84% of those survivors had survived for 5 or more years post-diagnosis.

“Our findings highlight that a singular focus on curing cancer yields an incomplete picture of childhood cancer survivorship,” lead author Siobhan M. Phillips, PhD, MPH, assistant professor of preventive medicine at Northwestern University Feinberg School of Medicine, said in a statement. “The burden of chronic conditions in this population is profound, both in occurrence and severity.”

For the study, researchers used cancer incidence and survival data recorded between 1975 and 2011 from nine US SEER registries, and data from the Childhood Cancer Survivor Study cohort, which provides information on a range of potential adverse and late effects of cancer treatment from more than 14,000 long-term survivors of childhood cancers at 26 cancer centers across the United States and Canada.

After analyzing the data, Phillips and colleagues estimated the number of childhood cancer survivors in the United States to be 388,501, which is an increase of 59,849 from the pervious estimate that was made in 2005 by the National Cancer Institute.

Of those survivors, about 84% had survived five or more years post-diagnosis.

However, the study found that about 70% of the survivors of childhood cancers were estimated to have a mild or moderate chronic condition whereas about 32% were estimated to have a severe, disabling, or life-threatening chronic condition.

“Efforts to understand how to effectively decrease morbidity burden and incorporate effective care coordination and rehabilitation models to optimize longevity and well-being in this population should be a priority,” Phillips said in a statement.

The results of the study showed that an estimated 35% of the survivors aged 20 to 49 had neurocognitive dysfunction and about 13% to 17% of those in this age group had self-reported functional impairment, activity limitations, impaired mental health, pain or anxiety and fear.

“We know that many of these morbidities are at least somewhat modifiable in the general population,” Phillips said. “However, we don’t know if typical population guidelines for preventive behaviors apply to this group.

“We need to develop a better understanding of the multilevel factors including, but not limited to, physical activity, diet, and treatment characteristics, which influence childhood cancer survivors’ susceptibility to these morbidities in order to effectively prevent and delay their onset.”