Childhood, adolescent, and young adult (CAYA) cancer survivors do not have an increased risk of testing positive for SARS-CoV-2 or developing severe COVID-19, compared with the general population, according to research published in the Journal of Clinical Oncology.
CAYA cancer survivors were no more likely to have a positive SARS-CoV-2 test result than a matched population control group. Furthermore, none of the infected cancer survivors were admitted to the intensive care unit or died after developing COVID-19.
Researchers conducted this population-based, retrospective cohort study to investigate if CAYA cancer survivors are at increased risk of testing positive for SARS-CoV-2 and having severe complications of COVID-19.
The study population comprised 12,410 five-year survivors of childhood cancers (diagnosed from birth to age 17 years between 1985 and 2014) or adolescent and young adult cancers (diagnosed at age 15 to 21 years between 1992 and 2012) registered with cancer registries in Ontario, Canada.
Each survivor was randomly matched by birth year, sex, and residence to 124,100 people who were cancer-free in a 10:1 ratio.
Cancer survivors had a roughly 20% higher rate of partial or full vaccination compared with the control group (partial vaccination: hazard ratio [HR], 1.21; 95% CI, 1.19-1.24; P <.001; full vaccination: HR, 1.23; 95% CI, 1.20-1.27; P <.001).
The cancer survivors were no more likely than the control population to have a positive SARS-CoV-2 test result — 3.1% and 3.2%, respectively (P =.68).
Similarly, the cancer survivors did not have an increased risk of emergency department visits (adjusted odds ratio [aOR], 1.2; 95% CI, 0.9-1.6; P =.19) or emergency hospitalization (aOR, 1.8; 95% CI, 1.0-3.5; P =.07), compared with the control population.
The researchers did not find a correlation between increased COVID-19 risk and pulmonary toxicity associated with pulmonary radiation or chemotherapy among cancer survivors.
Multivariable analyses in the cancer survivor cohort suggested the following factors are associated with an increased risk of testing positive for SARS-CoV-2 — younger age (OR, 0.99 per year; 95% CI, 0.98-1.0; P =.03), diabetes (OR, 1.8; 95% CI, 1.1-3.1; P =.03), and living in poorer urban neighborhoods.
“These results can inform risk-counseling of survivors and their caregivers. Further study is warranted to determine risk in older survivors, specific subsets of survivors, and that associated with novel COVID-19 variants,” the researchers wrote.
Disclosures: Some study authors declared affiliations with biotech, pharmaceutical, and/or device companies. Please see the original reference for a full list of disclosures.
Gupta S, Sutradhar R, Alexander S, et al. Risk of COVID-19 infections and of severe complications among survivors of childhood, adolescent, and young adult cancer: A population-based study in Ontario, Canada. J Clin Oncol. Published online February 28, 2022. doi:10.1200/JCO.21.02592