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. 2015 Apr;24(4):653-63.
doi: 10.1158/1055-9965.EPI-14-1418.

Survivors of childhood cancer in the United States: prevalence and burden of morbidity

Siobhan M Phillips  1 , Lynne S Padgett  2 , Wendy M Leisenring  3 , Kayla K Stratton  3 , Ken Bishop  2 , Kevin R Krull  4 , Catherine M Alfano  2 , Todd M Gibson  4 , Janet S de Moor  2 , Danielle Blanch Hartigan  5 , Gregory T Armstrong  4 , Leslie L Robison  4 , Julia H Rowland  2 , Kevin C Oeffinger  6 , Angela B Mariotto  2
Affiliations

Survivors of childhood cancer in the United States: prevalence and burden of morbidity

Siobhan M Phillips et al. Cancer Epidemiol Biomarkers Prev. 2015 Apr.

Abstract

Background: No studies have estimated the population-level burden of morbidity in individuals diagnosed with cancer as children (ages 0-19 years). We updated prevalence estimates of childhood cancer survivors as of 2011 and burden of morbidity in this population reflected by chronic conditions, neurocognitive dysfunction, compromised health-related quality of life, and health status (general health, mental health, functional impairment, functional limitations, pain, and fear/anxiety).

Methods: Surveillance, Epidemiology, and End Results (SEER) Program data from 1975 to 2011 were used to update the prevalence of survivors of childhood cancers in the United States. Childhood Cancer Survivor Study data were used to obtain estimates of morbidity burden indicators, which were then extrapolated to SEER data to obtain population-level estimates.

Results: There were an estimated 388,501 survivors of childhood cancer in the United States as of January 1, 2011, of whom 83.5% are ≥5 years after diagnosis. The prevalence of any chronic condition among ≥5-year survivors ranged from 66% (ages 5-19) to 88% (ages 40-49). Estimates for specific morbidities ranged from 12% (pain) to 35% (neurocognitive dysfunction). Generally, morbidities increased by age. However, mental health and anxiety remained fairly stable, and neurocognitive dysfunction exhibited initial decline and then remained stable by time since diagnosis.

Conclusions: The estimated prevalence of survivors of childhood cancer is increasing, as is the estimated prevalence of morbidity in those ≥5 years after diagnosis.

Impact: Efforts to understand how to effectively decrease morbidity burden and incorporate effective care coordination and rehabilitation models to optimize longevity and well-being in this population should be a priority.

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Conflict of interest statement

Conflicts of Interest: The authors have no conflicts of interest to disclose.

Figures

Figure 1
Figure 1
A. Estimates of the Prevalence of chronic health conditions in Childhood Cancer Survivors in the U.S. who Survived a Minimum of 5 years as of January 1, 2011 by Age. B. Estimates of the Prevalence of Chronic Conditions in Childhood Cancer Survivors in the U.S. who Survived a Minimum of 5 years as of January 1, 2011 by Gender and Age.
Figure 1
Figure 1
A. Estimates of the Prevalence of chronic health conditions in Childhood Cancer Survivors in the U.S. who Survived a Minimum of 5 years as of January 1, 2011 by Age. B. Estimates of the Prevalence of Chronic Conditions in Childhood Cancer Survivors in the U.S. who Survived a Minimum of 5 years as of January 1, 2011 by Gender and Age.
Figure 2
Figure 2. Estimates of the Prevalence of Neurocognitive Dysfunction and Compromised HRQOL and Health Status in Childhood Cancer Survivors in the U.S. who Survived a Minimum of 5 years by Age as of January 1, 2011
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