Childhood Cancer Survivors Lack Concern for Future Health Risks

In the United States, there are more than 15 million cancer survivors, and among them are 419,000 survivors who were under 20 years old when they first learned they had cancer, according to the American Cancer Society.

Those numbers are proof that advancements in anticancer treatment are keeping people alive longer. However, many of these treatments can lead to future health troubles, such as second cancers, heart problems, infertility and fatigue.

And now a recent study published in the journal Cancer finds that a good portion of childhood cancer survivors aren’t too concerned about their future health risks.

“The lack of concern is significant because some survivors may not engage in risk-reduction activities, such as recommended screening tests and healthy behaviors,” Todd Gibson, Ph.D., assistant member of the Epidemiology and Cancer Control Department at St. Jude Children’s Research Hospital in Memphis, Tennessee, and author on the study, said in an interview with CURE.

Researchers conducted the Childhood Cancer Survivor Study, which included 15,620 survivors of childhood cancer and 3,991 siblings who were asked to complete questionnaires. The median age was 26 years and median time since diagnosis was 17 years.

Survivors and siblings self-reported levels of concern about later health and the possibility of developing cancer again. Thirty-one percent of survivors were not concerned about future health and 40 percent were not worried about developing cancer. Compared with siblings, the prevalence of concern was higher or similar among survivors.

Those who were treated with high doses of radiation reported more concern. However, 24 percent were not worried about future health and 35 percent were not concerned with developing cancer.

“It was surprising to find that survivors and a comparison group of siblings were equally likely to report not being concerned about developing cancer,” Gibson said. “Even among survivors exposed to high doses of radiation, more than a third reported a lack of concern. More research is needed to understand how reported levels of concern influence the behaviors of survivors, but we found suggestive evidence that those who were not concerned about developing cancer were less likely to have had recommended screening tests.”

Survivors of childhood cancer have an increased risk for a range of health concerns, including an increased risk of developing a second cancer, Gibson explained. “Every childhood cancer survivor’s situation is unique, and future health problems, or late effects, are based on a variety of factors for that individual, including the type of cancer diagnosis, the cancer treatments received and other variables,” he said.

Gibson suggested ways in which survivors can be more involved in their health, such as being aware of prior cancer treatments and the associated health risks, working with health care providers to follow the established long-term follow-up care guidelines based on specific cancer history and becoming involved in dedicated survivorship care programs.

“It’s important to become an advocate for your health, by becoming well-versed in long-term follow-up care guidelines, and understanding risk based on your unique cancer history,” Gibson said. “The Children’s Oncology Group provides tools for survivors and primary care physicians to better understand the lasting effects of childhood cancer and its treatment.”

The next area of research is to try to understand the motivations behind survivors’ lack of concern and to better understand how lack of concern impacts survivors’ health behavior, Gibson said.