Risk of hospitalization increased for childhood cancer survivors, even years after treatment

Survivors of childhood cancers were hospitalized more often and had longer hospital admissions many years after cancer treatment was completed, compared with the general population.

Survivors were 52% more likely to be hospitalized, and their number of admissions was 67% higher, compared with age and sex-matched persons who did not have cancer. Survivors were 35% more likely to have stayed longer every time they were hospitalized, compared with controls.

"Our findings demonstrate that childhood cancer survivors face ongoing problems that can lead to hospitalization, even for those who are decades past their original cancer diagnosis. This can have a negative impact on their quality of life," said Anne C. Kirchhoff, PhD, MPH, assistant professor of pediatrics at the Huntsman Cancer Institute, University of Utah in Salt Lake City, Utah.

"Regular cancer-focused health care is important for identifying health problems for survivors throughout their lives," Kirchhoff added. "Patients and families who have experienced childhood cancer should obtain a cancer treatment summary and recommendations for follow-up care from their oncologist, and coordinate their follow-up care with their oncology and primary care doctors to ensure their health care needs are being managed."

Kirchhoff and colleagues identified 1,499 childhood cancer survivors treated between 1975 and 2005 who were at least 5 years past their original cancer diagnosis from the Utah Population Database (UPDB) and the Utah Cancer Registry. They collected data including demographic information, type of cancer, and type of treatment. Data on subsequent hospitalizations were obtained from the Utah Department of Health hospital discharge records. Using UPDB, they also identified 7,713 patients who did not have cancer; these patients served as age and sex-matched controls in this study.

About 50% of the survivors included in this study were female, and 98% were non-Hispanic whites. The researchers found that both female and male survivors were more likely to have been hospitalized than their respective controls. Female survivors had a longer average length of hospital stay than female controls.

More than 10% of those who survived central nervous system tumors, neuroblastoma, or malignant bone tumors were hospitalized five or more times during the follow-up period. Hospital admission rates were approximately two times higher for survivors of neuroblastoma and bone tumors compared with controls. "We saw higher rates of hospitalization across most cancer types, but not for all cancers, which gives us clues as to which groups of survivors may need better surveillance in the long term," said Kirchhoff.

Common reasons for hospitalization of survivors included blood disorders, anemia, and cancer. Infections, nervous system problems, and respiratory problems were other leading reasons for hospitalization.

This study was published in Cancer Epidemiology, Biomarkers & Prevention (doi: 10.1158/1055-9965.EPI-13-1090). Additional studies are planned to identify strategies to prevent and manage the health problems of survivors in the outpatient setting.

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