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Previous Volume 355:1572-1582 October 12, 2006 Number 15 Next

	Full Text PDF PDA Full Text Supplementary Material Perspective by Rosoff, P. M. Letters Add to Personal Archive Add to Citation Manager Notify a Friend E-mail When Cited E-mail When Letters Appear PubMed Citation

ABSTRACT

Background Only a few small studies have assessed the long-term morbidity that follows the treatment of childhood cancer. We determined the incidence and severity of chronic health conditions in adult survivors.

Methods The Childhood Cancer Survivor Study is a retrospective cohort study that tracks the health status of adults who received a diagnosis of childhood cancer between 1970 and 1986 and compares the results with those of siblings. We calculated the frequencies of chronic conditions in 10,397 survivors and 3034 siblings. A severity score (grades 1 through 4, ranging from mild to life-threatening or disabling) was assigned to each condition. Cox proportional-hazards models were used to estimate hazard ratios, reported as relative risks and 95% confidence intervals (CIs), for a chronic condition.

Results Survivors and siblings had mean ages of 26.6 years (range, 18.0 to 48.0) and 29.2 years (range, 18.0 to 56.0), respectively, at the time of the study. Among 10,397 survivors, 62.3% had at least one chronic condition; 27.5% had a severe or life-threatening condition (grade 3 or 4). The adjusted relative risk of a chronic condition in a survivor, as compared with siblings, was 3.3 (95% CI, 3.0 to 3.5); for a severe or life-threatening condition, the risk was 8.2 (95% CI, 6.9 to 9.7). Among survivors, the cumulative incidence of a chronic health condition reached 73.4% (95% CI, 69.0 to 77.9) 30 years after the cancer diagnosis, with a cumulative incidence of 42.4% (95% CI, 33.7 to 51.2) for severe, disabling, or life-threatening conditions or death due to a chronic condition.

Conclusions Survivors of childhood cancer have a high rate of illness owing to chronic health conditions.

Source Information

From Memorial Sloan-Kettering Cancer Center, New York (K.C.O., C.A.S.); the University of Minnesota, Minneapolis (A.C.M.); the Fred Hutchinson Cancer Research Center, Seattle (T.K., D.L.F., W.L.); St. Jude Children's Research Hospital, Memphis, TN (M.M.H., L.L.R.); Children's Hospital of Philadelphia, Philadelphia (A.T.M., W.H.); Stanford University Medical Center, Palo Alto, CA (N.M.); Yale University School of Medicine, New Haven, CT (N.S.K.-L.); and Brown Medical School, Providence, RI (C.L.S.).

Address reprint requests to Dr. Oeffinger at the Department of Pediatrics, Memorial Sloan-Kettering Cancer Center, 1275 York Ave., New York, NY 10021, or at oeffingk{at}mskcc.org.

Full Text of this Article

Related Letters:

Survivors of Childhood Cancer
Goodwin T., Oosterhuis B. E., Hayes-Lattin B., the LIVESTRONG Young Adult Alliance , Sharma N., Melgar T., Brands C., Haupt R., Jankovic M., Veerman A. J.P., the International Berlin–Frankfurt–Münster Early and Late Toxicity Educational Committee , Oeffinger K. C., Sklar C. A., Robison L. L., Rosoff P. M.
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N Engl J Med 2007; 356:191-194, Jan 11, 2007. Correspondence

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