Home Medizin Nur wenige Krebsüberlebende im Kindesalter erhalten empfohlene Vorsorgeuntersuchungen

Nur wenige Krebsüberlebende im Kindesalter erhalten empfohlene Vorsorgeuntersuchungen

von NFI Redaktion

According to a new study, the majority of childhood cancer survivors do not meet the surveillance guidelines recommending screening for cancer in adults or other long-term side effects of treatment.

In Ontario, Canada, 53% of childhood cancer survivors exposed to chemotherapy or radiation followed the screening recommendations for cardiomyopathy, 13% followed the screening guidelines for colorectal cancer, and 6% adhered to the screening guidelines for breast cancer.

Photo of Jennifer Shuldiner
Jennifer Shuldiner, PhD, MPH

„While over 80% of children diagnosed with cancer become long-term survivors, up to four out of five of these survivors develop severe or life-threatening late effects of their cancer therapy by the age of 45,“ said lead author Jennifer Shuldiner, PhD, MPH, a researcher at the Women’s College Hospital Institute for Health Systems Solutions and Virtual Care in Toronto, told Medical News Today.

For example, the risk of colorectal cancer is two to three times higher in childhood cancer survivors compared to the general population, and the risk of breast cancer is similar to those who have undergone breast irradiation or have a BRCA mutation. Up to 50% of those who received anthracycline chemotherapy or heart radiation later develop cardiotoxicity.

The North American Children’s Oncology Group has released long-term follow-up guidelines for childhood cancer survivors, but many survivors do not adhere to them due to lack of awareness or other barriers, Shuldiner said.

Previous studies have shown that many survivors do not undergo the recommended tests, she said. „With a better understanding of this vulnerable population, we can design, test, and implement appropriate interventions and support measures to address these issues.“

The study was published online on March 11 in CMAJ.

Changes in Adherence

The researchers conducted a retrospective population-based cohort study analyzing health administrative data from Ontario for adult survivors of childhood cancer diagnosed between 1986 and 2014 who were at increased risk for therapy-related colorectal cancer, breast cancer, or cardiomyopathy. The research team then assessed long-term compliance with the North American Children’s Oncology Group guidelines and predictors of compliance.

Of the 3,241 survivors, 3,205 (99%) were at increased risk for cardiomyopathy, 327 (10%) were at increased risk for colorectal cancer, and 234 (7%) were at increased risk for breast cancer. Additionally, 2,806 (87%) were at risk of one late effect, 345 (11%) were at risk of two late effects, and 90 (3%) were at risk of three late effects.

Overall, 53%, 13%, and 6% adhered to the recommended surveillance for cardiomyopathy, colorectal cancer, and breast cancer, respectively. Over time, adherence to colorectal cancer and cardiomyopathy increased, while adherence to breast cancer guidelines decreased.


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