In a study reported in the Journal of Clinical Oncology, Esbenshade et al found that survivors of childhood cancer were more likely to accumulate comorbidities over time than their siblings or the general population.
Study Details
In the study, Cumulative Illness Rating Scale for Geriatrics (CIRS-G) total score (TS) was calculated for cancer survivors and their siblings in a Childhood Cancer Survivor Study cohort. The TS was determined at baseline survey (between 1992 and 2005) and 19-year follow-up survey (2014 and 2016), and in a National Health and Nutrition Examination Survey (NHANES) cohort of 31,126 individuals from 1999 to 2004.
Key Findings
A total of 14,355 survivors (median age = 24 years, interquartile range [IQR] = 8–30 years) and 4,022 siblings (median age = 26 years, IQR = 19–33 years) provided baseline data; 6,138 survivors and 1,801 siblings provided follow-up data. Survivors had a higher median CIRS-G TS vs siblings at baseline (5.75 vs 3.44, P < .01) and follow-up (7.76 vs 4.79, P < .01).
The mean increase in TS from baseline to follow-up was significantly greater in survivors (2.89 in males and 3.18 in females) vs siblings (1.79 in males and 1.69 in females, P <.01) and the NHANES cohort (2.0 in males and 1.94 in females, P < .01). Each point increase from baseline TS increased the risk of death by 9% (95% confidence interval = 8%–10%) among survivors.
The investigators concluded, “Application of a geriatric rating scale to characterize disease supports the hypothesis that morbidity accumulation is accelerated in young adult survivors of childhood cancer when compared with siblings and the general population.”
Adam J. Esbenshade, MD, MSCI, of the Division of Pediatric Hematology and Oncology, Vanderbilt University School of Medicine and the Monroe Carell Jr. Children’s Hospital at Vanderbilt, is the corresponding author for the Journal of Clinical Oncology article.
Disclosure: The study was supported by the National Cancer Institute and American Lebanese-Syrian Associated Charities. For full disclosures of the study authors, visit ascopubs.org.
