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Comparative Study
. 2015 Feb 10;33(5):479-91.
doi: 10.1200/JCO.2014.57.4863. Epub 2014 Dec 29.

Age-dependent changes in health status in the Childhood Cancer Survivor cohort

Melissa M Hudson  1 , Kevin C Oeffinger  2 , Kendra Jones  2 , Tara M Brinkman  2 , Kevin R Krull  2 , Daniel A Mulrooney  2 , Ann Mertens  2 , Sharon M Castellino  2 , Jacqueline Casillas  2 , James G Gurney  2 , Paul C Nathan  2 , Wendy Leisenring  2 , Leslie L Robison  2 , Kirsten K Ness  2
Affiliations
Comparative Study

Age-dependent changes in health status in the Childhood Cancer Survivor cohort

Melissa M Hudson et al. J Clin Oncol. .

Abstract

Purpose: To compare age-dependent changes in health status among childhood cancer survivors and a sibling cohort.

Methods: Adult survivors of childhood cancer and siblings, all participants of the Childhood Cancer Survivor Study, completed three surveys assessing health status. At each of three time points, participants were classified as having poor outcomes in general health, mental health, function, or daily activities if they indicated moderate to extreme impairment. Generalized linear mixed models were used to compare survivors with siblings for each outcome as a function of age and to identify host- and treatment-related factors associated with age-dependent worsening health status.

Results: Adverse health status outcomes were more frequent among survivors than siblings, with evidence of a steeper trajectory of age-dependent change among female survivors with impairment in at least one health status domain (P = .01). In adjusted models, survivors were more likely than siblings to report poor general health (prevalence ratio [PR], 2.37; 95% CI, 2.09 to 2.68), adverse mental health (PR, 1.66; 95% CI, 1.52 to 1.80), functional impairment (PR, 4.53; 95% CI, 3.91 to 5.24), activity limitations (PR, 2.38; 95% CI, 2.12 to 2.67), and an adverse health status outcome in any domain (PR, 2.10; 95% CI, 1.97 to 2.23). Cancer treatment and health behaviors influence the magnitude of differences by age groups. Chronic conditions were associated with adverse health status outcomes across organ systems.

Conclusion: The prevalence of poor health status is higher among survivors than siblings, increases rapidly with age, particularly among female participants, and is related to an increasing burden of chronic health conditions.

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Conflict of interest statement

Authors' disclosures of potential conflicts of interest are found in the article online at www.jco.org. Author contributions are found at the end of this article.

Figures

Fig 1.
Fig 1.
Prevalence of survivors and siblings with a poor health status outcome in (A) any domain, (B) general health, (C) mental health, (D) function, and (E) activity by age, with prevalence ratios for each adverse outcome, comparing survivors to siblings by five-year age group.
See this image and copyright information in PMC

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