Survivors of Childhood Cancers Experience Frequent Hospitalizations Years After Cancer Treatment
Childhood and adolescent cancer survivors often face ongoing health problems that require frequent and long hospital stays many years after their cancer diagnosis and treatment, according to a new study by Kirchhoff et al published in Cancer Epidemiology, Biomarkers & Prevention. Survivors of childhood cancers such as as leukemia, lymphoma, and central nervous system (CNS) cancers were at risk for longer hospital stays—35% longer for lymphoma and approximately 60% longer for both leukemia and CNS tumors—compared with the general population. Some reasons for the hospitalizations included blood diseases, such as anemia, and cancer recurrences, metastatic disease, and/or secondary cancers.
The study authors identified 1,499 childhood cancer survivors treated between 1975 and 2005 who were at least 5 years past their original cancer diagnosis from the Utah Population Database (UPDB) and the Utah Cancer Registry. A noncancer comparison cohort of 7,713 subjects, selected on birth year and sex, was sampled from Utah birth certificates through the UPDB. The information collected included demographics, type of cancer, and type of treatment. Data on subsequent hospitalizations were obtained from the Utah Department of Health hospital discharge records.
Study Findings
About 50% of the survivors in the study were female, and 98% were non-Hispanic white. The researchers found that both female survivors and male survivors were 52% more likely to have been hospitalized than their respective controls. Female survivors also had a longer average length of hospital stay (4.55 days on average) than the female controls (3.07 days). Male survivors had the longest average length of stay, with 5.40 days of hospitalization compared with 4.04 for female survivors, 3.83 days for the male comparison, and 2.72 days for the female comparison.
More than 10% of survivors of CNS tumors, neuroblastoma, or malignant bone tumors were hospitalized five or more times during the follow-up period, and the hospital admission rates were approximately two times higher for survivors of neuroblastoma and bone tumors compared with the control group.
Common reasons for more frequent hospitalization of survivors compared with controls included blood disorders, such as anemia, and cancer, although it is unclear if this was for their original cancer diagnosis or new cancers. Infections, nervous system problems, and respiratory problems were other leading reasons for hospitalizations.
Growing Problem
“Our findings demonstrate that childhood cancer survivors face ongoing problems that can lead to hospitalization, even for those who are decades past their original cancer diagnosis,” said Anne C. Kirchhoff, PhD, MPH, lead author of the study and Assistant Professor of Pediatrics at the Huntsman Cancer Institute of the University of Utah in Salt Lake City, in a statement. “This can negatively impact their quality of life.”
As the number of childhood survivors continues to grow, according to the study authors, the high hospitalization rate indicates that care for these survivors will have an increasing impact on the U.S. health-care system.
“Our findings demonstrate that survivors of child and adolescent cancer require better strategies to prevent, manage, and treat conditions before they become severe enough to require hospitalization,” concluded the researchers.
Dr. Kirchhoff is the corresponding author for the Cancer Epidemiology, Biomarkers & Prevention article.
Funding for this study was provided by a Huntsman Cancer Institute Control and Population Sciences Research Award, the Huntsman Cancer Foundation, a Primary Children’s Medical Foundation Career Development Award, the Utah Cancer Registry, and the National Institutes of Health. The study authors reported no conflicts of interest.
The content in this post has not been reviewed by the American Society of Clinical Oncology, Inc. (ASCO®) and does not necessarily reflect the ideas and opinions of ASCO®.
