title: Chronic health conditions in adult survivors of childhood cancer.
abstract: BACKGROUND
  Only a few small studies have assessed the long-term morbidity that follows the treatment of childhood cancer. We determined the incidence and severity of chronic health conditions in adult survivors.
  
  
  METHODS
  The Childhood Cancer Survivor Study is a retrospective cohort study that tracks the health status of adults who received a diagnosis of childhood cancer between 1970 and 1986 and compares the results with those of siblings. We calculated the frequencies of chronic conditions in 10,397 survivors and 3034 siblings. A severity score (grades 1 through 4, ranging from mild to life-threatening or disabling) was assigned to each condition. Cox proportional-hazards models were used to estimate hazard ratios, reported as relative risks and 95% confidence intervals (CIs), for a chronic condition.
  
  
  RESULTS
  Survivors and siblings had mean ages of 26.6 years (range, 18.0 to 48.0) and 29.2 years (range, 18.0 to 56.0), respectively, at the time of the study. Among 10,397 survivors, 62.3% had at least one chronic condition; 27.5% had a severe or life-threatening condition (grade 3 or 4). The adjusted relative risk of a chronic condition in a survivor, as compared with siblings, was 3.3 (95% CI, 3.0 to 3.5); for a severe or life-threatening condition, the risk was 8.2 (95% CI, 6.9 to 9.7). Among survivors, the cumulative incidence of a chronic health condition reached 73.4% (95% CI, 69.0 to 77.9) 30 years after the cancer diagnosis, with a cumulative incidence of 42.4% (95% CI, 33.7 to 51.2) for severe, disabling, or life-threatening conditions or death due to a chronic condition.
  
  
  CONCLUSIONS
  Survivors of childhood cancer have a high rate of illness owing to chronic health conditions.
authors.affiliation: Department of Pediatrics, Memorial Sloan-Kettering Cancer Center, New York 10021, USA. oeffingk@mskcc.org
authors.forename: Kevin C
authors.initials: KC
authors.lastname: Oeffinger
authors.forename: Ann C
authors.initials: AC
authors.lastname: Mertens
authors.forename: Charles A
authors.initials: CA
authors.lastname: Sklar
authors.forename: Toana
authors.initials: T
authors.lastname: Kawashima
authors.forename: Melissa M
authors.initials: MM
authors.lastname: Hudson
authors.forename: Anna T
authors.initials: AT
authors.lastname: Meadows
authors.forename: Debra L
authors.initials: DL
authors.lastname: Friedman
authors.forename: Neyssa
authors.initials: N
authors.lastname: Marina
authors.forename: Wendy
authors.initials: W
authors.lastname: Hobbie
authors.forename: Nina S
authors.initials: NS
authors.lastname: Kadan-Lottick
authors.forename: Cindy L
authors.initials: CL
authors.lastname: Schwartz
authors.forename: Wendy
authors.initials: W
authors.lastname: Leisenring
authors.forename: Leslie L
authors.initials: LL
authors.lastname: Robison
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D002908:Chronic Disease / Q000453:epidemiology*; D015331:Cohort Studies; D005260:Female; D006304:Health Status; D006801:Humans; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000150:complications* / Q000628:therapy; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D012306:Risk; D035781:Siblings; D017741:Survivors / Q000706:statistics & numerical data*