Study reports lack of concern about future health among childhood cancer survivors

In the largest study to date that examined concerns of adult survivors of childhood cancer, a substantial proportion of survivors reported lack of concern about their future health. Published early online in CANCER, a peer-reviewed journal of the American Cancer Society, the findings suggest that many survivors may not fully understand or acknowledge their increased risks for later health problems.

Survivors of childhood cancer are at elevated risk for serious chronic health conditions and subsequent cancers due to the long-term effects of chemotherapy and radiation treatments. Little is known about survivors' perceptions of their future health risks, however.

To investigate, a team led by Leslie Robison, PhD, and Todd Gibson, PhD, of St. Jude Children's Research Hospital in Memphis, Tennessee, examined responses to questionnaires completed by adult survivors of childhood cancer and siblings of adult cancer survivors. A total of 15,620 adult survivors of childhood cancer (median age 26 years, 17 years since diagnosis) and 3,991 siblings in the Childhood Cancer Survivor Study provided responses related to levels of concern about future health and subsequent cancer.

The researchers found that 31 percent of survivors were not concerned about their future health and 40 percent were not concerned about developing cancer. The prevalence of concern in survivors was modestly higher or similar compared with siblings. Survivors exposed to high doses of radiation were more likely to report concern, but 35 percent of these high-risk survivors were not concerned about developing cancer and 24 percent were not concerned about their future health.

The authors note that survivors who are unconcerned about their risks may be less likely to engage in cancer screening and activities that reduce their risk.

"Some of the increased health risks faced by survivors of childhood cancer can be minimized through early detection and intervention, as well as adoption of healthy behaviors," said Dr. Gibson. "Many survivors do not have survivor-focused medical care, so it is important for them to be aware of their health risks and advocate for appropriate guideline-based care. A lack of concern about potential health risks may be a barrier to this self-advocacy and adoption of healthy behaviors; however, it is important to note that not all survivors are at high risk, so for some a lack of concern is likely appropriate."