Health Status of Adult Long-term Survivors of Childhood Cancer: A Report From the Childhood Cancer Survivor Study
- 24 September 2003
- journal article
- research article
- Published by American Medical Association (AMA) in JAMA
- Vol. 290 (12), 1583-1592
- https://doi.org/10.1001/jama.290.12.1583
Abstract
Adult survivors of childhood cancer are at risk for medical and psychosocial sequelae that may adversely affect their health status.To compare the health status of adult survivors of childhood cancer and siblings and to identify factors associated with adverse outcomes.Health status was assessed in 9535 adult participants of the Childhood Cancer Survivor Study, a cohort of long-term survivors of childhood cancer who were diagnosed between 1970 and 1986. A randomly selected cohort of the survivors' siblings (n = 2916) served as a comparison group.Six health status domains were assessed: general health, mental health, functional status, activity limitations, cancer-related pain, and cancer-related anxiety/fears. The first 4 domains were assessed in the control group.Survivors were significantly more likely to report adverse general health (odds ratio [OR], 2.5; 95% confidence interval [CI], 2.1-3.0; P<.001), mental health (OR, 1.8; 95% CI, 1.6-2.1; P<.001), activity limitations (OR, 2.7; 95% CI, 2.3-3.3; P<.001), and functional impairment (OR, 5.2; 95% CI, 4.1-6.6; P<.001), compared with siblings. Forty-four percent of survivors reported at least 1 adversely affected health status domain. Sociodemographic factors associated with reporting at least 1 adverse health status domain included being female (OR, 1.4; 95% CI, 1.3-1.6; P<.001), lower level of educational attainment (OR, 2.0; 95% CI, 1.8-2.2; P<.001), and annual income less than 20 000 dollars (OR, 1.8; 95% CI, 1.6-2.1; P<.001). Relative to those survivors with childhood leukemia, an increased risk was observed for at least 1 adverse health status domain among those with bone tumors (OR, 2.1; 95% CI, 1.8-2.5; P<.001), central nervous system tumors (OR, 1.7; 95% CI, 1.5-2.0; P<.001), and sarcomas (OR, 1.2; 95% CI, 1.1-1.5; P =.01).Clinicians caring for adult survivors of childhood cancer should be aware of the substantial risk for adverse health status, especially among females, those with low educational attainment, and those with low household incomes.This publication has 20 references indexed in Scilit:
- Late Effects of Childhood Cancer and Its TreatmentPediatric Clinics of North America, 2015
- Medical and neurocognitive late effects among survivors of childhood central nervous system tumorsCancer, 2001
- Cancer and Cardiac Mortality Among 15-Year Survivors of Cancer Diagnosed During Childhood or AdolescenceJournal of Clinical Oncology, 1999
- Health status and health-related quality of life in long-term adult survivors of pediatric solid tumorsInternational Journal of Cancer, 1999
- Late mortality of long-term survivors of childhood cancer.Journal of Clinical Oncology, 1997
- Late deaths and survival after childhood cancer: implications for cureBMJ, 1994
- Death during adulthood in survivors of childhood and adolescent cancerCancer, 1994
- Factors that influence the further survival of patients who survive for five years after the diagnosis of cancer in childhood or adolescenceMedical and Pediatric Oncology, 1994
- A comprehensive multiattribute system for classifying the health status of survivors of childhood cancer.Journal of Clinical Oncology, 1992
- Late deaths after treatment for childhood cancer.Archives of Disease in Childhood, 1990