(HealthDay News) — By age 50 years, more than half of childhood cancer survivors have experienced a severe, disabling, life-threatening, or fatal health condition, according to a study published online March 17 in the Journal of Clinical Oncology.

Gregory T. Armstrong, MD, from the St. Jude Children’s Research Hospital in Memphis, TN, and colleagues examined health risks across the aging spectrum for 14,359 5-year survivors from the Childhood Cancer Survivor Study, who were diagnosed before age 21 years and were followed for a median of 24.5 years, and 4,301 of their siblings. At the last follow-up, 5,604 of the survivors were at least 35 years old.

The researchers found that, by age 50 years, survivors had an increased cumulative incidence of a severe, disabling, life-threatening, or fatal health condition, compared with their siblings (53.6% vs. 19.8%).

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The hazard ratios (HRs) were significantly increased for survivors versus siblings within age groups: 5 to 19 years (HR, 6.8); 20 to 34 years (HR, 3.8); and 35 years or older (HR, 5.0).

Compared with 6.0% of siblings, 25.9% of survivors who reached age 35 years without a previous grade 3 or 4 condition experienced a subsequent grade 3 to 5 condition within 10 years (P < 0.001).

“Elevated risk for morbidity and mortality among survivors increases further beyond the fourth decade of life, which affects the future clinical demands of this population relative to ongoing surveillance and interventions,” the researchers wrote.


  1. Armstrong GT, Kawashima T, Leisenring W, et al. Aging and Risk of Severe, Disabling, Life-Threatening, and Fatal Events in the Childhood Cancer Survivor Study. J Clin Oncol. 2014; doi:10.1200/JCO.2013.51.1055.