03 Dec 2021
2 minutes reading
Source/Revelations
disclosures:
Frederiksen and colleagues report no relevant financial disclosures.
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Childhood cancer survivors had an increased risk of long-term psychiatric disorders compared to their siblings or peers, according to a registry-based cohort study.
Significant improvements in childhood cancer treatment and survival over the past 5 decades, with 5-year survival rates currently exceeding 80% in most European countries and North America, have led to a steadily growing population of survivors of cancer. childhood cancer,” Line Elmerdahl Frederiksen, PhD, from the Danish Cancer Society Research Center, and colleagues wrote in Lancet Psychiatry. “Individuals who have had childhood cancer may have a higher lifelong risk of adverse health problems and socioeconomic challenges than their peers. While many survivors are generally coping well, it has become clear that survivors are at an overall increased risk of several somatic late effects.”
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The researchers analyzed data from more than 18,000 5-year-old childhood cancer survivors diagnosed before the age of 20 between January 1, 1974 and December 31, 2011, in Denmark, Finland and Sweden. They compared survivors (n = 18,621; 53.3% boys) with their siblings (n = 24,775; 50.8% boys) and randomly selected controls (n = 88,630; 53.4% boys) from the general population who were matched to survivors based on birth year, sex, and geographic region. They followed participants from 5 years after diagnosis or index date for matched individuals through August 11, 2017. They also examined hospital contact data for specific psychiatric disorders. They defined the index date for siblings as 5 years after the date they were the same age as their surviving sibling when they were diagnosed with cancer.
The results showed a cumulative incidence rate of 15.9% (95% CI, 15.3-16.5) for childhood cancer survivors aged 30 years between January 1, 1979 and August 11, 2017, 14% (95% CI, 13.5–14.5) for their siblings and 12.7% (95% CI, 12.4–12.9) for the matched individuals. The study further showed that childhood cancer survivors had a relatively higher risk of any psychiatric hospital contact compared to their siblings (1.39%; 95% CI, 1.31–1.48) and matched individuals (HR = 1 .34; 95% CI, 1.28–1.39) , with that risk remaining 50 years old. Compared to their siblings and matched cohorts, survivors had a higher burden for recurrent psychiatric hospital contacts and had more hospital contacts for various psychiatric disorders.
“Child cancer survivors are at higher long-term risk for psychiatric disorders than their siblings and matched individuals from the general population,” Frederiksen and colleagues wrote. “To improve mental health and overall quality of life after childhood cancer, follow-up care should focus on early signs of mental health problems, especially in high-risk groups of survivors.”
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