Young Cancer Survivors Face Later Cardiovascular Risks
Childhood Cancer Survivor Study data show cardiac risk persists decades after cancer is gone
WEDNESDAY, Dec. 9 (HealthDay News) -- Chemotherapy or radiation therapy for cancer in childhood or adolescence substantially increases the risk of a cardiac condition later in life, according to a study published online Dec. 8 in BMJ.
Daniel A Mulrooney, M.D., of the University of Minnesota Medical School and Masonic Cancer Center in Minneapolis, and colleagues followed a cohort of 14,358 subjects who had survived cancer diagnosed before the age of 21 years, including leukemia, Hodgkin's lymphoma, non-Hodgkin's lymphoma, brain cancer, kidney cancer, neuroblastoma, soft tissue sarcoma or bone cancer. Through a questionnaire, the researchers determined the incidence of cardiac conditions, and compared it to that of 3,899 siblings without cancer.
The investigators found that the cancer survivors had an elevated risk for cardiac conditions compared to the sibling control group, including pericardial disease (hazard ratio, 6.3), congestive heart failure (hazard ratio, 5.9), myocardial infarction (hazard ratio, 5.0) and valve abnormalities (hazard ratio, 4.8). Within the survivors group, certain levels of anthracycline exposure during chemotherapy increased the risk of congestive heart failure, pericardial disease and valve abnormalities an estimated two to five times compared to unexposed survivors, while 1500 centigray or more of cardiac radiation exposure increased the risks of congestive heart failure, myocardial infarction, pericardial disease and valve abnormalities two to six times. The incidence of adverse cardiac outcomes persisted up to 30 years.
"Survivors of childhood and adolescent cancer are at substantial risk for cardiovascular disease. Health care professionals must be aware of these risks when caring for this growing population," the authors write.