Advances in treatment have not yielded better long-term health outcomes for childhood cancer survivors
Survivors treated in more recent decades may have access to more organized follow-up care and educational materials about late effects of treatment and, therefore, may be more likely to anticipate or report adverse outcomes, study authors noted.
Therapeutic advances have improved over the past 30 years, but adult survivors of childhood cancer continue to report poor physical and mental health status, possibly because this population now includes those who would have died in earlier decades, a study found.
Researchers conducted a cross-sectional study across 27 North American institutions to compare self-reported health status by treatment decade (1970s, 1980s, or 1990s) of 14,566 adult cancer survivors who participated in the Childhood Cancer Survivor Study (CCSS) and their siblings. Patient diagnosis, cancer treatment exposure, chronic health conditions, demographic characteristics, and health habits were examined.
Study results were published online Nov. 8 by Annals of Internal Medicine.
Despite an overall decline in radiation exposure, reduced mean chemotherapy doses, and decreased proportions of survivors with more severe chronic health conditions, patient-reported health status generally did not improve across treatment decades, the authors found. Late mortality and the proportions of survivors with severe, disabling, or life-threatening chronic health conditions decreased by treatment decade, but the percentage of survivors reporting adverse health status did not. Compared with survivors diagnosed in 1970 to 1979, those diagnosed in 1990 to 1999 were more likely to report poor general health (11.2% vs. 13.7%; P<0.001) and cancer-related anxiety (13.3% vs. 15.0%; P<0.001).
The authors suggest that survivors treated in more recent decades may have access to more organized follow-up care and educational materials about late effects of treatment and, therefore, may be more likely to anticipate or report adverse outcomes.
“Improved survival after a diagnosis of childhood cancer is a success story in modern medicine,” the authors wrote. “Surprisingly, our data show lack of improvement in health status among childhood cancer survivors over 30 years of evolving cancer therapy—an important reminder that the cure for cancer is not without consequences.”