Effect of Temporal Changes in Therapeutic Exposure on Self-reported Health Status in Childhood Cancer Survivors

• DOI: 10.7326/m16-0742
• Publication Date: 2018-01-24T17:31:02Z
• Authors: Kirsten K. Ness; Melissa M. Hudson; Kendra E. Jones; Wendy Leisenring; Yutaka Yasui; Yan Chen; Marilyn Stovall; Todd M. Gibson; Daniel M. Green; Joseph P. Neglia; Tara O. Henderson; Jacqueline Casillas; Jennifer S. Ford; Karen E. Effinger; Kevin R. Krull; Gregory T. Armstrong; Leslie L. Robison; Kevin C. Oeffinger; Paul C. Nathan
• Keywords: Childhood Cancer

The effect of temporal changes in cancer therapy on health status among childhood survivors has not been evaluated.To compare proportions self-reported adverse outcomes across 3 decades.Cross-sectional. (ClinicalTrials.gov: NCT01120353).27 North American institutions.14 566 adults, who survived for 5 or more years after initial diagnosis (median age, 27 years; range, 18 to 48 years), treated from 1970 1999.Patient report poor general mental health, functional impairment, activity limitation, cancer-related anxiety pain was evaluated as a function treatment decade, exposure, chronic conditions, demographic characteristics, and habits.Despite reductions late mortality the with severe, disabling, life-threatening conditions (33.4% those 1979 21.0% 1990 1999), reporting did decrease by decade. Compared diagnosed 1979, 1999 were likely (11.2% vs. 13.7%; P < 0.001) (13.3% 15.0%; 0.001). From 1999, higher (P leukemia (poor 9.5% 13.9%) osteosarcoma (pain, 23.9% 36.6%). Temporal exposures associated status. Smoking, meeting physical guidelines, being either underweight obese status.Considerable improvement survival children 1990s compared 1970s makes it difficult definitively determine risk factors later without considering their mortality.Because rates have improved substantially over past 30 years, population now includes would died earlier decades. Self-reported despite evolution designed reduce toxicities.The National Cancer Institute.