5/24/10 - Health Woes Common in Childhood Cancer Survivors

Kids who survive cancer in childhood are more likely to have poorer health when they grow up, a new study says.

Researchers say adults who survive childhood cancer also are more likely to be limited in their ability to work and face limitations in daily functioning, including eating, dressing, and going to the toilet.

Such limitations decrease the productivity of adults who survive cancer as youths, the study says.

The study suggests that the effects of childhood cancer are long-lasting and that the medical community should pay special attention to the health risks associated with childhood cancer in survivors for as long as they live.

This is critical, the researchers say, because the number of survivors of childhood cancer has been increasing because of earlier detection and more effective treatments and medications.

Researchers led by Emily Dowling, MHS, of the National Cancer Institute set out to gauge the burdens childhood survivors might face as adults.

They analyzed information on 410 adults who had survived cancer as children as well as data on 294,641 adults who had not had any cancerous diseases. Then they compared answers to a series of questions about their health and various abilities to function.

They found that:

• Survivors were more likely to report their health status as fair or poor, compared to adults who had not had cancer as children. Among respondents, 24.3% of cancer survivors reported themselves in fair or poor condition, vs. 10.9% of adults who’d never had cancer.
• 12.9% of cancer survivors reported having health limitations in their lives, compared to 3.4% of people who had not had cancer in childhood.
• 20.9% of childhood cancer survivors reported being unable to work in adulthood because of health problems, compared to 6.3% of people who’d been well throughout their youth.
• 30.9% of adult survivors of childhood cancer said they were limited in the amount or type of work they could do because of health problems. Researchers say 10.6% of other adults without a cancer history gave that answer.
• Fewer survivors reported having a job in the past year compared to people who had never had cancer.
• Adult survivors were more likely to be younger, not married (or separated), and to be non-Hispanic whites compared to people who had not had cancer in childhood.
• Adult survivors also were more likely to report having public health insurance, without supplemental private or military coverage. Having public health insurance, the authors say, can affect access and quality of care, because some doctors do not accept patients with public health insurance. Also, some survivors may report worse outcomes as adults because they delayed needed care because of cost.

The researchers say that adult survivors of childhood cancer had poorer health outcomes at all time intervals checked. They reported the greatest limitations in the first four years after diagnosis, and 30 or more years later.

Among those reporting problems three decades or more after diagnosis:

• 43.8% said they were limited in the amount or type of work they could do as a result of cancer-related health problems.
• 39.8% reported themselves as being in fair or poor health.
• This group of long-term survivors reported missing an average of 69.3 days of work in the past year because of health problems.
• It is possible that the survivors making reports after 30 years were more prone to health problems because of the types of cancer treatment that were available in the 1970s and 1980s, according to the study.
• Problems in activities of daily living cited by survivors included trouble eating, bathing, dressing, getting in or out of bed or other furniture, using the toilet, and getting around inside their homes.

“Our study suggests that adult survivors of childhood cancer deserve special medical attention and may benefit from interventions to improve their health and productivity,” Dowling says in a news release.

The study is published in Cancer, a publication of the American Cancer Society.