Late mortality and chronic health conditions in long-term survivors of early-adolescent and young adult cancers: a retrospective cohort analysis from the Childhood Cancer Survivor Study

Suh, Eugene; Stratton, Kayla; Leisenring, Wendy M.; Nathan, Paul C.; Ford, Jennifer S.; Freyer, David R.; McNeer, Jennifer L.; Stock, Wendy; Stovall, Marilyn; Krull, Kevin R.; Sklar, Charles A.; Neglia, Joseph P.; Armstrong, Gregory T.; Oeffinger, Kevin C.; Robison, Leslie L.; Henderson, Tara O.

doi:10.1016/s1470-2045(19)30800-9

Cited by 221 publications

(174 citation statements)

References 25 publications

Supporting

Mentioning

149

Contrasting

Unclassified

Order By: Relevance

“…[2][3][4] In addition, compared with older patients with cancer, AYAs have a higher risk of long-term and late effects, including infertility, sexual dysfunction, cardiovascular disease, and future cancers, [5][6][7][8] whereas compared with childhood cancer survivors, the risk of severe late effects is lower. 9 AYAs are also more likely than older patients with cancer to experience delays in diagnosis for some cancers because of higher uninsured rates, a lack of cost-effective early detection methods, and the rarity of cancer at this age. 10,11 Despite rapid progress in the scientific understanding of cancer in AYAs, important research gaps in etiology, basic biology, treatment, and survivorship persist, partly because this age group continues to be grouped with children and/ or older adults in many epidemiologic studies.…”

Section: Introductionmentioning

confidence: 99%

Cancer statistics for adolescents and young adults, 2020

Miller

Fidler-Benaoudia²,

Keegan

et al. 2020

CA A Cancer J Clinicians

778

571

View full text Add to dashboard Cite

Cancer statistics for adolescents and young adults (AYAs) (aged 15-39 years) are often presented in aggregate, masking important heterogeneity. The authors analyzed population-based cancer incidence and mortality for AYAs in the United States by age group (ages 15-19, 20-29, and 30-39 years), sex, and race/ ethnicity. In 2020, there will be approximately 89,500 new cancer cases and 9270 cancer deaths in AYAs. Overall cancer incidence increased in all AYA age groups during the most recent decade (2007-2016), largely driven by thyroid cancer, which rose by approximately 3% annually among those aged 20 to 39 years and 4% among those aged 15 to 19 years. Incidence also increased in most age groups for several cancers linked to obesity, including kidney (3% annually across all age groups), uterine corpus (3% in the group aged 20-39 years), and colorectum (0.9%-1.5% in the group aged 20-39 years). Rates declined dramatically for melanoma in the group aged 15 to 29 years (4%-6% annually) but remained stable among those aged 30 to 39 years. Overall cancer mortality declined during 2008 through 2017 by 1% annually across age and sex groups, except for women aged 30 to 39 years, among whom rates were stable because of a flattening of declines in female breast cancer. Rates increased for cancers of the colorectum and uterine corpus in the group aged 30 to 39 years, mirroring incidence trends. Five-year relative survival in AYAs is similar across age groups for all cancers combined (range, 83%-86%) but varies widely for some cancers, such as acute lymphocytic leukemia (74% in the group aged 15-19 years vs 51% in the group aged 30-39 years) and brain tumors (77% vs 66%), reflecting differences in histologic subtype distribution and treatment. Progress in reducing cancer morbidity and mortality among AYAs could be addressed through more equitable access to health care, increasing clinical trial enrollment, expanding research, and greater alertness among clinicians and patients for early symptoms and signs of cancer. Further progress could be accelerated with increased disaggregation by age in research on surveillance, etiology, basic biology, and survivorship. CA Cancer

show abstract

Section: Introductionmentioning

confidence: 99%

Cancer statistics for adolescents and young adults, 2020

Miller

Fidler-Benaoudia²,

Keegan

et al. 2020

CA A Cancer J Clinicians

778

571

View full text Add to dashboard Cite

show abstract

“…Pediatric cancer survivors are not spared from the pandemic. In addition to dealing with a wide array of sequelae of the cancer and related treatments, which includes fatigue, 1 weakened immune system, 2 a reduced functional capacity, 3 and psychological problems, 4 pediatric cancer survivors who are immunocompromised now face an increased susceptibility to COVID‐19 infection. This results in an immense level of additional pressure in their families during the pandemic.…”

mentioning

confidence: 99%

Health support to pediatric cancer survivors and their families during the COVID‐19 pandemic

Cheung

Chan

et al. 2020

Pediatric Blood & Cancer

View full text Add to dashboard Cite

“…Our cohort was skewed toward craniopharyngioma and other midline tumors. Most of these received radiation and hypothalamic exposure put them at higher risk of developing dysautonomia, obesity, and endocrinopathy 11,12,14 . However, we do not believe this contributed meaningfully to their cognitive dysfunction as our surveillance program recognized and treated the endocrinopathies under the care of an endocrinologist.…”

Section: Discussionmentioning

confidence: 95%

“…Studies on children taking stimulants also suggest a loss of 1‐2 cm in potential height gain and this may be relevant to brain tumor survivors who are at risk of short stature, especially when spine or hypothalamus are irradiated 11 . Childhood cancer survivors are also at a higher risk of developing cardiovascular morbidity, 12 and there are limited data on cardiovascular effects of stimulants in childhood brain tumor and cancer survivors. Furthermore, survivors of midline tumors treated with radiation are at higher risk of dysautonomia, and this may predispose them to a greater risk of heart rate fluctuation in response to stimulant medications 13…”

Section: Introductionmentioning

confidence: 99%

Height, weight, and cardiovascular effects of stimulants on children with brain tumors

Khan

Bano

Wang

et al. 2020

Pediatric Blood & Cancer

View full text Add to dashboard Cite

Introduction: Children with brain tumors may develop inattention, slow processing, and hypersomnia. Stimulant medications improve these problems, but their effect on growth, heart rate, and blood pressure (BP) are inadequately explored. Procedure: We retrospectively studied children with brain tumors treated at our institution that had data available for 1 year pre and 2 years on stimulant treatment. Tumor location, gender, radiation treatment (RT), age at RT, drug type, and hormone therapy were variables of interest. Results: We identified 65 children (35 males) that fulfilled eligibility criteria. Focal RT was utilized in 58; 11 additionally had whole brain RT; and seven received no RT. Thirty were treated for hypersomnia and inattention, eight for hypersomnia alone, and rest for inattention. Modafinil was the first drug in 18 (27.7%), and methylphenidate in the others. Forty-seven (72.3%), 45 (69.2%), and 49 (75.4%) were on thyroxine, cortisone, and growth hormones, respectively. There was no difference in pre-and post-stimulant body mass index (BMI), heart rate, and BP. There was also no difference between modafinil and methylphenidate groups. Rate of height acquisition slowed on stimulants (P = .0096). Thyroxine treatment correlated with increase in BMI after stimulants (P = .04). Younger age (P = .0003) and higher prestimulant BMI (P = .0063) correlated with increased heart rate on stimulants, while higher age at RT (P =.016) correlated with elevated systolic BP on stimulants. No associations were found with height acquisition and diastolic BP. Conclusion: Stimulants are well tolerated by children with brain tumors that are appropriately managed for endocrine deficiencies, but may reduce the trajectory of height attainment. K E Y W O R D S blood pressure, brain tumors, childhood, heart rate, stimulants, weight 1 INTRODUCTION A significant number of childhood brain tumor survivors develop neurocognitive impairment, particularly attention span, processing speed, Abbreviations: BMI, body mass index; BP, blood pressure; RT, radiation treatment and working memory. 1,2 Cognitive deficits may result from effect of radiation and chemotherapy on the brain, or due to the direct tumor effect. 3 Latter may represent involvement of eloquent areas of brain by the tumor or disruption of brain connectivity. Younger age and radiation treatment (RT) are the most important risk factors for cognitive impairment in childhood brain tumor survivors, and may be related to loss of gray and white matter volume. 1,2,4,5

show abstract

Late mortality and chronic health conditions in long-term survivors of early-adolescent and young adult cancers: a retrospective cohort analysis from the Childhood Cancer Survivor Study

Cited by 221 publications

References 25 publications

Cancer statistics for adolescents and young adults, 2020

Cancer statistics for adolescents and young adults, 2020

Health support to pediatric cancer survivors and their families during the COVID‐19 pandemic

Height, weight, and cardiovascular effects of stimulants on children with brain tumors

Contact Info

Product

Resources

About