Congenital Anomalies in the Children of Cancer Survivors: A Report From the Childhood Cancer Survivor Study

2012 ◽  
Vol 2012 ◽  
pp. 230-232
Author(s):  
R.J. Arceci
Keyword(s):  
Cancer Survivors ◽  
Childhood Cancer ◽  
Cancer Survivor ◽  
Congenital Anomalies ◽  
Childhood Cancer Survivor ◽  
Childhood Cancer Survivor Study

scholarly journals Congenital Anomalies in the Children of Cancer Survivors: A Report From the Childhood Cancer Survivor Study

2012 ◽  
Vol 30 (3) ◽  
pp. 239-245 ◽  
Author(s):  
Lisa B. Signorello ◽  
John J. Mulvihill ◽  
Daniel M. Green ◽  
Heather M. Munro ◽  
Marilyn Stovall ◽  
...  
Keyword(s):  
Radiation Dose ◽  
Cancer Survivors ◽  
Childhood Cancer ◽  
Cancer Survivor ◽  
Congenital Anomalies ◽  
Alkylating Agents ◽  
Childhood Cancer Survivor ◽  
Individual Treatment ◽  
Increased Risk ◽  
Childhood Cancer Survivor Study

Purpose Children with cancer receive mutagenic treatments, which raises concern about the potential transmissibility of germline damage to their offspring. This question has been inadequately studied to date because of a lack of detailed individual treatment exposure assessment such as gonadal radiation doses. Methods Within the Childhood Cancer Survivor Study, we performed a retrospective cohort analysis of validated cases of congenital anomalies among 4,699 children of 1,128 male and 1,627 female childhood cancer survivors. We quantified chemotherapy with alkylating agents and radiotherapy doses to the testes and ovaries and related these exposures to risk of congenital anomalies using logistic regression. Results One hundred twenty-nine children had at least one anomaly (prevalence = 2.7%). For children whose mothers were exposed to radiation or alkylating agents versus neither, the prevalence of anomalies was 3.0% versus 3.5% (P = .51); corresponding figures were 1.9% versus 1.7% (P = .79) for the children of male survivors. Neither ovarian radiation dose (mean, 1.19 Gy; odds ratio [OR] = 0.59; 95% CI, 0.20 to 1.75 for 2.50+ Gy) nor testicular radiation dose (mean, 0.48 Gy; OR = 1.01; 95% CI, 0.36 to 2.83 for 0.50+ Gy) was related to risk of congenital anomalies. Treatment with alkylating agents also was not significantly associated with anomalies in the children of male or female survivors. Conclusion Our findings offer strong evidence that the children of cancer survivors are not at significantly increased risk for congenital anomalies stemming from their parent's exposure to mutagenic cancer treatments. This information is important for counseling cancer survivors planning to have children.

scholarly journals Mortality After Breast Cancer Among Survivors of Childhood Cancer: A Report From the Childhood Cancer Survivor Study

2019 ◽  
Vol 37 (24) ◽  
pp. 2120-2130 ◽  
Author(s):  
Chaya S. Moskowitz ◽  
Joanne F. Chou ◽  
Joseph P. Neglia ◽  
Ann H. Partridge ◽  
Rebecca M. Howell ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cancer Survivors ◽  
Childhood Cancer ◽  
Cancer Survivor ◽  
De Novo ◽  
Childhood Cancer Survivors ◽  
Childhood Cancer Survivor ◽  
Malignant Neoplasms ◽  
Childhood Cancer Survivor Study ◽  
Survivors Of Childhood Cancer

PURPOSE Female survivors of childhood cancer have a high risk of subsequent breast cancer. We describe the ensuing risk for mortality and additional breast cancers. PATIENTS AND METHODS Female participants in the Childhood Cancer Survivor Study, a cohort of 5-year survivors of cancer diagnosed between 1970 and 1986 before age 21 years, and subsequently diagnosed with breast cancer (n = 274; median age at breast cancer diagnosis, 38 years; range, 20 to 58 years) were matched to a control group (n = 1,095) with de novo breast cancer. Hazard ratios (HRs) and 95% CIs were estimated from cause-specific proportional hazards models. RESULTS Ninety-two childhood cancer survivors died, 49 as a result of breast cancer. Overall survival after breast cancer was 73% by 10 years. Subsequent risk of death as a result of any cause was higher among childhood cancer survivors than among controls (HR, 2.2; 95% CI, 1.7 to 3.0) and remained elevated after adjusting for breast cancer treatment (HR, 2.4; 95% CI, 1.7 to 3.2). Although breast cancer–specific mortality was modestly elevated among childhood cancer survivors (HR, 1.3; 95% CI, 0.9 to 2.0), survivors were five times more likely to die as a result of other health-related causes, including other subsequent malignant neoplasms and cardiovascular or pulmonary disease (HR, 5.5; 95% CI, 3.4 to 9.0). The cumulative incidence of a second asynchronous breast cancer also was elevated significantly compared with controls ( P < .001). CONCLUSION Mortality after breast cancer was higher in childhood cancer survivors than in women with de novo breast cancer. This increased mortality reflects the burden of comorbidity and highlights the need for risk-reducing interventions.

Prevalence and predictors of posttraumatic stress disorder in adult survivors of childhood cancer: A report from the Childhood Cancer Survivor Study

2009 ◽  
Vol 27 (18_suppl) ◽  
pp. CRA10002-CRA10002
Author(s):  
M. Stuber ◽  
K. Meeske ◽  
B. Zebrack ◽  
K. Krull ◽  
K. Stratton ◽  
...  
Keyword(s):  
Posttraumatic Stress Disorder ◽  
Cancer Survivors ◽  
Childhood Cancer ◽  
Posttraumatic Stress ◽  
Cancer Survivor ◽  
Stress Disorder ◽  
Childhood Cancer Survivors ◽  
Childhood Cancer Survivor ◽  
Self Report ◽  
Childhood Cancer Survivor Study

CRA10002 Background: This study examined prevalence and demographic- and disease-related correlates of posttraumatic stress disorder (PTSD) among 6,542 adult childhood cancer survivors and 368 siblings from the Childhood Cancer Survivor Study. Methods: Subjects were dichotomized based on full PTSD criteria, using the Foa PTSD self-report measure to assess posttraumatic stress symptoms of intrusion of unwanted memories, avoidance of event reminders, and increased startle response, and the Brief Symptom Inventory-18 and the SF-36 subscale, role limitation due to emotional health, to evaluate clinical distress or impaired function. A self-report questionnaire provided demographic information and medical abstraction provided cancer reatment data. Multivariable generalized linear models were used to compare prevalence of PTSD among cancer survivors to siblings and to examine relationships between PTSD and demographic and disease-related factors. Relative risks (RR) were calculated based on a Poisson distribution with robust error variances. Results: Five hundred eighty-nine (9%) childhood cancer survivors and 8 (2%) siblings met criteria for a diagnosis of PTSD (RR = 3.83, 95% CI 1.96–7.48, p < 0.0001). Among cancer survivors, there was significantly more PTSD reported by women from minority backgrounds (p < 0.05). Other demographic factors associated with PTSD were having less than a college education (p < 0.05), being unmarried (p < 0.001), having an annual income less than $20,000 (p < 0.05) and being unemployed (p = 0.001). Risk of PTSD was significantly higher for survivors diagnosed at ages 15 to 20 years (p < 0.05). PTSD was more common among survivors treated with intensive chemotherapy (p < 0.05) or radiation therapy (p < 0.001) and who relapsed or developed a second malignant neoplasm (p < 0.001). Neuroblastoma and Wilms tumor survivors had a significantly lower risk of PTSD than did leukemia survivors (p < 0.05). Conclusions: While the majority of childhood cancer survivors did not demonstrate PTSD, a clinically significant number did meet diagnostic criteria. Prospective assessment of survivors with high risk demographic-, diagnosis-, and treatment-related characteristics should be considered as part of long-term health screening. No significant financial relationships to disclose.

scholarly journals The Childhood Cancer Survivor Study: A National Cancer Institute–Supported Resource for Outcome and Intervention Research

2009 ◽  
Vol 27 (14) ◽  
pp. 2308-2318 ◽  
Author(s):  
Leslie L. Robison ◽  
Gregory T. Armstrong ◽  
John D. Boice ◽  
Eric J. Chow ◽  
Stella M. Davies ◽  
...  
Keyword(s):  
Cancer Survivors ◽  
Childhood Cancer ◽  
Cancer Survivor ◽  
National Cancer Institute ◽  
Survival Rates ◽  
Childhood Cancer Survivor ◽  
Related Factors ◽  
Dynamic Framework ◽  
Adolescent Cancer ◽  
Childhood Cancer Survivor Study

Survival for childhood cancer has increased dramatically over the last 40 years with 5-year survival rates now approaching 80%. For many diagnostic groups, rapid increases in survival began in the 1970s with the broader introduction of multimodality approaches, often including combination chemotherapy with or without radiation therapy. With this increase in rates of survivorship has come the recognition that survivors are at risk for adverse health and quality-of-life outcomes, with risk being influenced by host-, disease-, and treatment-related factors. In 1994, the US National Cancer Institute funded the Childhood Cancer Survivor Study, a multi-institutional research initiative designed to establish a large and extensively characterized cohort of more than 14,000 5-year survivors of childhood and adolescent cancer diagnosed between 1970 and 1986. This ongoing study, which reflects the single most comprehensive body of information ever assembled on childhood and adolescent cancer survivors, provides a dynamic framework and resource to investigate current and future questions about childhood cancer survivors.

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