Chronic conditions commonly affect long-term quality of life for survivors of childhood cancer who are in their young adult years, defined as age 18 to 29 years. Young adult survivors of childhood cancer reported overall health-related quality of life similar to that of adults in the general population in their 40s.
The presence or absence of chronic conditions is a key variable to determining a person’s sense of well-being. Survivors of childhood cancer have higher risks of heart disease, infertility, lung disease, cancers, and other chronic health conditions. These risks are increased largely because of their prior chemotherapy, radiation, and surgery.
This study surveyed 7105 survivors of childhood cancer, 372 siblings of survivors, and 12 803 members of the general population. Only 20% of the childhood cancer survivors reported no chronic conditions.
As survival of childhood cancer has substantially increased since the 1970s, research into pediatric cancer has expanded into ways to reduce the toxicity of treatment. The goals are to minimize late effects as well as cure the disease.
“This research provides an easily accessible way to compare adult survivors of childhood cancer to the general population, in terms of their health-related quality of life, which normally declines as people age,” said Lisa Diller, MD, chief medical officer of Dana-Farber/Boston Children’s Cancer and Blood Disorders Center in Boston, Massachusetts, and senior author of the study.
“Our findings indicate survivors’ accelerated aging and also help us understand the health-related risks associated with having had cancer as a child. What’s encouraging is that the lower quality of life scores are associated with chronic disease after treatment, not with a history of pediatric cancer itself. If we can prevent treatment-related conditions by changes in the therapy we use for the cancer, then childhood cancer will become an acute, rather than a chronic, illness.”
The young adult survivors had an average health-related quality of life score of 0.78, on a 0 to 1 scale, which is roughly equivalent to that reported by adults age 40 to 49 years in the general population. Scores were lower for persons with more chronic conditions.
“By enabling comparisons to the general population, our findings provide context to better understand how the cancer experience may influence the long-term well-being of survivors,” said Jennifer Yeh, PhD, a research scientist in the Center for Health Decision Science at the Harvard Chan School, and lead author of the study. “This is another way to understand the health challenges survivors face and where to focus efforts to improve the long-term health and quality of life of survivors.”
1. Yeh JM, Hanmer J, Ward ZJ, et al. Chronic conditions and utility-based health-related quality of life in adult childhood cancer survivors [published online ahead of print April 21 2016]. J Natl Cancer Inst. doi:10.1093/jnci/djw046.