Survivors of Pediatric Cancers Suffering Less From Chronic Diseases

CHICAGO — Modifications in treatment protocols for cancers in children have prolonged their lives while reducing the incidence of serious chronic illnesses, investigators reported at the American Society of Clinical Oncology (ASCO) Annual Meeting.¹

Todd M. Gibson, PhD, of St. Jude Children’s Research Hospital, Memphis, Tennessee, and collaborators analyzed data from 23,601 pediatric cancer survivors in the Childhood Cancer Survivor Study, with a median age of 28 years (range 5-63 years) and median time from cancer diagnosis of 21 years. The 15-year cumulative incidence of Common Terminology Criteria for Adverse Events (CTCAE) grade 3 to 5 chronic health conditions declined from 12.7% among survivors whose cancer was diagnosed in the 1970s to 10.1% and 8.9% among those whose cancer was diagnosed in the 1980s and 1990s, respectively. The risk of chronic diseases by 15 years after diagnosis decreased by 18% in each successive decade. The association of chronic diseases with cancer diagnosis decade was attenuated when detailed treatment data were taken into account, indicating that changes in treatment over time played a role in reducing risk, Dr Gibson reported.

“Our results demonstrate that the incredible efforts by oncologists and others in recent decades to modify childhood cancer treatments have translated to a reduced incidence of serious late health effects in many long-term survivors of childhood cancer,” Dr Gibson said.

Decreases were driven largely by a reduced incidence of endocrine conditions and subsequent malignant neoplasms, the study showed. The incidence of endocrine conditions declined from 4.0% in the 1970s to 1.6% in the 1990s and the incidence of subsequent malignant neoplasms decreased from 2.4% in the 1970s to 1.6% in the 1990s. After adjusting for sex and attained age, the risk of endocrine conditions and subsequent malignant neoplasms decreased by 34% (CI, 0.59-0.73) and 15% (0.76-0.96), respectively. The study also revealed significant decreases in the incidence of gastrointestinal and neurological conditions, but not cardiac or pulmonary conditions.

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Reference

1. Gibson TM, Mostoufi-Moab S, Stratton K, et al. Temporal trends in chronic disease among survivors of childhood cancer diagnosed across three decades: a report from the Childhood Cancer Survivor Study (CCSS). Oral presentation at: 2017 American Society of Clinical Oncology Annual Meeting; June 2-6, 2017; Chicago, IL.