A study from St. Jude Children’s Research Hospital, coauthored by Marilyn Stovall from the University of Texas MD Anderson Cancer Center in Houston, reinforces the need for lifelong surveillance of childhood cancer survivors. Looking at 14,359 adult survivors who had cancer at the age of 20 years or younger between the years 1970 and 1986, St. Jude Researchers found a distinct difference between the survivors and 4,301 siblings. “Survivors remain at risk for serious health problems into their 40s and 50s, decades after they have completed treatment for childhood cancer,” said Gregory Armstrong, M.D., from the St. Jude Department of Epidemiology and Cancer Control, about the study published in the Journal of Clinical Oncology.
Survivors ages 20 to 34 years developed a severe, disabling, life-threatening, or fatal health condition 3.8 times more often than siblings of the same age. The higher risk jumped to 5 times more often when survivors and siblings aged more than 35 years were considered. “In fact, for survivors, the risk of illness and death increases significantly beyond the age of 35. Their siblings don’t share these same risks,” said Dr. Armstrong. Past the age of 50 years, more than half of the survivors had a life-altering health problem, compared to only 20% of siblings.
Even if survivors had not developed a serious health problem by 35 years of age, 25.9% went on to develop a problem in the next decade; only 6% of siblings had their first health problem between the ages of 35 and 45 years. Armstrong suggested that these health problems can be mitigated in survivors by follow-up exams, such as mammograms, at ages earlier than those recommended for the general public in order to identify problems early and prevent their development.
Additionally, the study showed evidence that survivors may experience accelerated aging due to cancer treatment. Survivors only 24 years old had the same rates of severe, life-threatening, or fatal health problems as their siblings who were 50 years old.
Cancer therapies have certainly evolved since 1970/1986, which means that long-term pediatric cancer survival rates have risen to 80%, and the difference in survivorship will soon affect many more individuals than the current 363,000 pediatric cancer survivors in the United States. St. Jude researchers are constantly studying strategies to educate and empower survivors and developed screening guidelines in collaboration with the Children’s Oncology Group.