Increasingly effective cancer treatments and resulting improvements in survival times are swelling the ranks of the cancer-survivor population. Many children, adolescents, and young adults diagnosed with cancer are now surviving decades after treatment.
Surprisingly little is known about how cancer treatment in early life affects health in adulthood. But now, 2 studies published in JAMA Oncology shed new light on those long-term health risks.1,2
One of the studies looked at long-term hospitalization risk in 35 555 5-year survivors of cancers during adolescence and young adulthood (AYA), defined as diagnosis at age 15 to 39 years.1
The study team found that at a median follow-up of 14 years, these patients saw a total of 53 032 hospitalizations, compared to 38 423 among sex- and age-matched controls. AYA cancer survivors face up to twice the risk of blood diseases overall—and up to 6 times the risk among leukemia survivors in particular—as well as infections, and second cancers.1
“The risk for hospitalization is strongly related to the type of cancer and the type of treatment received. We know that survivors of leukemia, brain tumors, and Hodgkin lymphoma receive lengthy and intensive treatments and these cancer survivors were also those at highest risk,” said lead author Kathrine Rugbjerg, PhD, of the Danish Cancer Society Research Center in Copenhagen, Denmark.
“However, it should be kept in mind that survivors of all of the 10 most-common cancers in adolescents and young adults were at increased risk for hospitalization when compared to a comparable population with no history of cancer,” she told Cancer Therapy Advisor.
Better prioritizing follow-up for patients who face high risks of severe diseases and hospitalization would be “one major step forward in easing the burden of adverse health problems in this vulnerable group of cancer survivors,” Dr. Rugbjerg said.
A separate study showed that long-term survivors of childhood osteosarcoma were also at risk of neurocognitive deficits in adulthood, but that these impairments seemed to be associated with current adult cardiopulmonary conditions, and not high-dose methotrexate cancer treatment received during childhood.2
The link to cardiopulmonary health was a “key finding,” said the senior author of that study, Kevin R. Krull, PhD, of the Department of Epidemiology and Cancer Control at St. Jude Children’s Research Hospital in Memphis, TN.
“It tells us that if we can maintain good cardiac health in these survivors as they age into middle adulthood, they may be at less risk for cognitive problems,” he told Cancer Therapy Advisor.
The study demonstrated the need for continued long-term follow-up for childhood osteosarcoma survivors, especially regarding cardiopulmonary conditions, concurred Yutaka Yasui, PhD, a professor at the University of Alberta in Canada and a member of Dr. Krull’s department at St. Jude Children’s Research Hospital, who was not involved in the study.