Childhood cancer survivors can reduce risk of dying with healthy lifestyle
CANCER DIGEST – May 2, 2023 – Survivors of childhood cancer are at increased risk of dying from common causes such as cancer, heart disease and stroke even 40 years after their diagnosis, however survivors who maintained healthy lifestyles substantially reduced their risk of dying, a new study published April 29, 2023 in The Lancet shows.
"Much research has demonstrated that (childhood cancer) survivors are vulnerable to early onset of chronic disease and mortality," said co-author Melissa Hudson, M.D., St. Jude Cancer Survivorship Division director. "The study highlights the importance of encouraging survivors to practice healthy behaviors and maintain good control of cardiovascular disease risk factors to improve their health-span and lifespan."
The study, which involved more than 34,000 survivors of the most common childhood cancers diagnosed between 1970 and 1999 in the USA and Canada, found that they had 131 excess deaths per 10,000 person-years from health-related causes compared to the general population. Health-related causes include deaths related to late effects of cancer therapy but exclude deaths due to the primary cancer or external and accidental causes.
The researchers identified over 70 specific causes of death using a modification of established codes from the Centers for Disease Control and National Vital Statistics Report and found that the top three causes of health-related death in the general population - cancer, heart disease and cerebrovascular disease - were also the leading causes of excess death among childhood cancer survivors.
The data also showed that modifiable lifestyle and cardiovascular risk factors such as smoking, obesity, physical inactivity, hypertension and diabetes were associated with a 20%-30% reduction in health-related mortality independent of other factors among the childhood cancer survivors. In other words, childhood cancer survivors with high blood pressure or diabetes had a significantly higher mortality than survivors without those conditions.
The authors suggest that interventions targeting these risk factors should be part of future strategies to improve the long-term health and survival of childhood cancer survivors.