title: Self-reported endocrine late effects in adults treated for brain tumours, Hodgkin and non-Hodgkin lymphoma: a registry based study in Northern Germany.
abstract: OBJECTIVE
  Due to the increasing success and survival rates in the primary treatment of malignancies derived from the CNS as well as the hematopoietic system, endocrine late effects of cancer and its therapy are of growing importance. Despite evaluation of these late effects in patients treated for cancer in childhood, the impact on adults remains largely unclear.
  
  
  METHODS
  1035 adult patients primarily diagnosed with a CNS malignancy, a Hodgkin (HL) or non-Hodgkin lymphoma (NHL) between 1998 and 2008 were recruited via the regional epidemiological cancer registry covering ∼ 2.8 million inhabitants in the federal state of Schleswig-Holstein, Northern Germany. The prevalence of endocrine disorders and current psychosocial impairment was assessed employing several questionnaires (SF-36v1, WHO-5).
  
  
  RESULTS
  Fully completed questionnaires of 558 patients were available for subsequent analysis showing markedly reduced overall performance and psychological status when compared to German reference data. Thyroid disorders were reported in 16.3% of patients with 10.4% suffering from hypo- and 5.9% from hyperthyroidism. Overall, 17.6% stated to be affected by diabetes mellitus with an increased rate of 21.1% among NHL patients and 11.5% of participants were affected by osteoporosis.
  
  
  CONCLUSIONS
  Compared to German population based studies on the prevalence of diabetes mellitus, osteoporosis and thyroid disorders the frequency of all these endocrine problems was significantly increased in CNS, HL, and NHL cancer survivors. These data confirm that not only children and adolescents but also adult cancer patients are at risk for therapy associated endocrine late effects.
authors.affiliation: Experimental and Clinical EndocrinologyDepartment of Internal Medicine I, University Hospital of Schleswig-Holstein, Campus Luebeck, Ratzeburger Allee 160, 23538 Luebeck, GermanyInstitute of Social Medicine and EpidemiologyUniversity Luebeck, Ratzeburger Allee 160, 23538 Luebeck, GermanyDepartment of Pediatric Hematology and OncologyUniversity Hospital of Schleswig-Holstein, Campus Luebeck, Ratzeburger Allee 160, 23538 Luebeck, GermanyDepartment of NeurosurgeryUniversity Hospital of Essen, Hufelandstr. 55, 45147 Essen, Germany andInstitute of Cancer Epidemiology e.V.University Luebeck, Ratzeburger Allee 160, 23538 Luebeck, Germany.
authors.forename: Judith
authors.initials: J
authors.lastname: Gebauer
authors.affiliation: Experimental and Clinical EndocrinologyDepartment of Internal Medicine I, University Hospital of Schleswig-Holstein, Campus Luebeck, Ratzeburger Allee 160, 23538 Luebeck, GermanyInstitute of Social Medicine and EpidemiologyUniversity Luebeck, Ratzeburger Allee 160, 23538 Luebeck, GermanyDepartment of Pediatric Hematology and OncologyUniversity Hospital of Schleswig-Holstein, Campus Luebeck, Ratzeburger Allee 160, 23538 Luebeck, GermanyDepartment of NeurosurgeryUniversity Hospital of Essen, Hufelandstr. 55, 45147 Essen, Germany andInstitute of Cancer Epidemiology e.V.University Luebeck, Ratzeburger Allee 160, 23538 Luebeck, Germany.
authors.forename: Eva-Maria
authors.initials: EM
authors.lastname: Fick
authors.affiliation: Experimental and Clinical EndocrinologyDepartment of Internal Medicine I, University Hospital of Schleswig-Holstein, Campus Luebeck, Ratzeburger Allee 160, 23538 Luebeck, GermanyInstitute of Social Medicine and EpidemiologyUniversity Luebeck, Ratzeburger Allee 160, 23538 Luebeck, GermanyDepartment of Pediatric Hematology and OncologyUniversity Hospital of Schleswig-Holstein, Campus Luebeck, Ratzeburger Allee 160, 23538 Luebeck, GermanyDepartment of NeurosurgeryUniversity Hospital of Essen, Hufelandstr. 55, 45147 Essen, Germany andInstitute of Cancer Epidemiology e.V.University Luebeck, Ratzeburger Allee 160, 23538 Luebeck, Germany.
authors.forename: Annika
authors.initials: A
authors.lastname: Waldmann
authors.affiliation: Experimental and Clinical EndocrinologyDepartment of Internal Medicine I, University Hospital of Schleswig-Holstein, Campus Luebeck, Ratzeburger Allee 160, 23538 Luebeck, GermanyInstitute of Social Medicine and EpidemiologyUniversity Luebeck, Ratzeburger Allee 160, 23538 Luebeck, GermanyDepartment of Pediatric Hematology and OncologyUniversity Hospital of Schleswig-Holstein, Campus Luebeck, Ratzeburger Allee 160, 23538 Luebeck, GermanyDepartment of NeurosurgeryUniversity Hospital of Essen, Hufelandstr. 55, 45147 Essen, Germany andInstitute of Cancer Epidemiology e.V.University Luebeck, Ratzeburger Allee 160, 23538 Luebeck, Germany.
authors.forename: Thorsten
authors.initials: T
authors.lastname: Langer
authors.affiliation: Experimental and Clinical EndocrinologyDepartment of Internal Medicine I, University Hospital of Schleswig-Holstein, Campus Luebeck, Ratzeburger Allee 160, 23538 Luebeck, GermanyInstitute of Social Medicine and EpidemiologyUniversity Luebeck, Ratzeburger Allee 160, 23538 Luebeck, GermanyDepartment of Pediatric Hematology and OncologyUniversity Hospital of Schleswig-Holstein, Campus Luebeck, Ratzeburger Allee 160, 23538 Luebeck, GermanyDepartment of NeurosurgeryUniversity Hospital of Essen, Hufelandstr. 55, 45147 Essen, Germany andInstitute of Cancer Epidemiology e.V.University Luebeck, Ratzeburger Allee 160, 23538 Luebeck, Germany.
authors.forename: Ilonka
authors.initials: I
authors.lastname: Kreitschmann-Andermahr
authors.affiliation: Experimental and Clinical EndocrinologyDepartment of Internal Medicine I, University Hospital of Schleswig-Holstein, Campus Luebeck, Ratzeburger Allee 160, 23538 Luebeck, GermanyInstitute of Social Medicine and EpidemiologyUniversity Luebeck, Ratzeburger Allee 160, 23538 Luebeck, GermanyDepartment of Pediatric Hematology and OncologyUniversity Hospital of Schleswig-Holstein, Campus Luebeck, Ratzeburger Allee 160, 23538 Luebeck, GermanyDepartment of NeurosurgeryUniversity Hospital of Essen, Hufelandstr. 55, 45147 Essen, Germany andInstitute of Cancer Epidemiology e.V.University Luebeck, Ratzeburger Allee 160, 23538 Luebeck, Germany.
authors.forename: Hendrik
authors.initials: H
authors.lastname: Lehnert
authors.affiliation: Experimental and Clinical EndocrinologyDepartment of Internal Medicine I, University Hospital of Schleswig-Holstein, Campus Luebeck, Ratzeburger Allee 160, 23538 Luebeck, GermanyInstitute of Social Medicine and EpidemiologyUniversity Luebeck, Ratzeburger Allee 160, 23538 Luebeck, GermanyDepartment of Pediatric Hematology and OncologyUniversity Hospital of Schleswig-Holstein, Campus Luebeck, Ratzeburger Allee 160, 23538 Luebeck, GermanyDepartment of NeurosurgeryUniversity Hospital of Essen, Hufelandstr. 55, 45147 Essen, Germany andInstitute of Cancer Epidemiology e.V.University Luebeck, Ratzeburger Allee 160, 23538 Luebeck, Germany.
authors.forename: Alexander
authors.initials: A
authors.lastname: Katalinic
authors.affiliation: Experimental and Clinical EndocrinologyDepartment of Internal Medicine I, University Hospital of Schleswig-Holstein, Campus Luebeck, Ratzeburger Allee 160, 23538 Luebeck, GermanyInstitute of Social Medicine and EpidemiologyUniversity Luebeck, Ratzeburger Allee 160, 23538 Luebeck, GermanyDepartment of Pediatric Hematology and OncologyUniversity Hospital of Schleswig-Holstein, Campus Luebeck, Ratzeburger Allee 160, 23538 Luebeck, GermanyDepartment of NeurosurgeryUniversity Hospital of Essen, Hufelandstr. 55, 45147 Essen, Germany andInstitute of Cancer Epidemiology e.V.University Luebeck, Ratzeburger Allee 160, 23538 Luebeck, Germany georg.brabant@uksh.de.
authors.forename: Georg
authors.initials: G
authors.lastname: Brabant
mesh_terms: D000328:Adult; D000368:Aged; D001932:Brain Neoplasms / Q000453:epidemiology* / Q000628:therapy; D015331:Cohort Studies; D003920:Diabetes Mellitus / Q000139:chemically induced / Q000175:diagnosis / Q000453:epidemiology; D004700:Endocrine System Diseases / Q000139:chemically induced / Q000175:diagnosis / Q000453:epidemiology*; D005260:Female; D005858:Germany / Q000453:epidemiology; D006689:Hodgkin Disease / Q000453:epidemiology* / Q000628:therapy; D006801:Humans; D008228:Lymphoma, Non-Hodgkin / Q000453:epidemiology* / Q000628:therapy; D008297:Male; D008875:Middle Aged; D010024:Osteoporosis / Q000139:chemically induced / Q000175:diagnosis / Q000453:epidemiology; D012042:Registries; D057566:Self Report; D013959:Thyroid Diseases / Q000139:chemically induced / Q000175:diagnosis / Q000453:epidemiology; D013997:Time Factors; D016896:Treatment Outcome