A new study shows that adult survivors of childhood cancer are at significant risk for health problems as they age, and are five times more likely than their siblings to have health problems after age 35.

Adult survivors of childhood cancer require long-term health monitoring for the rest of their lives. This message comes from St. Jude Children’s Research Hospital, in the wake of recent findings from the Childhood Cancer Survivor Study (CCSS).

The study, which was published in the Journal of Clinical Oncology, found that adult survivors of childhood cancer face significant health problems as they grow older. What’s more, they are five times more likely than their siblings to develop new cancers, heart problems, and other serious health conditions after age 35.

The oldest survivors in this study were in their 50s. The CCSS study also found that the health gap between survivors and their siblings widens with age. Survivors who were 20 to 34 years old were 3.8 times more likely than siblings of the same age to have experienced severe, disabling, life-threatening, or fatal health conditions. By age 35 and beyond, however, survivors were at five-fold greater risk.

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By the time they reach 50 years of age, more than half of childhood cancer survivors had experienced a life-changing health problem, versus less than one-fifth of siblings that were the same age.

More than 22 percent of survivors had at least two serious health problems, while about 10 percent mentioned that they had three or more serious health problems. New cancers and diseases of the heart, lungs, liver, kidneys, and hormones were reported.

There are now more than 363,000 pediatric cancer survivors in the U.S. An overall long-term pediatric cancer survival rate of 80 percent means the number of survivors will increase, according to St. Jude.

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Gregory Armstrong, M.D., an associate member of the St. Jude Department of Epidemiology and Cancer Control and the lead author of the CCSS study, issued a statement advising that survivors remain at risk for serious health problems into their 40s and 50s, decades after they have completed treatment for childhood cancer. “In fact, for survivors, the risk of illness and death increases significantly beyond the age of 35. Their siblings don’t share these same risks,” said Armstrong.

In survivors who celebrated their 35thbirthday without serious health problems, 25.9 percent had a significant health problem in the next decade, compared with 6 percent of siblings. The siblings developed their first serious health problem between 35 and 45 years of age.

The study evaluated 14,359 adult survivors who were treated for a variety of pediatric cancers at one of 26 U.S. and Canadian medical centers, with a focus on 5,604 survivors who are now over 35 years of age. In addition, 4,301 siblings were studied.

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The findings underscore the necessity of lifelong, risk-based health care for cancer survivors, according to Armstrong. Depending on their cancer treatment and other risk factors, Armstrong suggested that mammograms and other health checks be conducted at a younger age than is recommended for the general public as part of follow-up care.

Many screenings are designed to identify health problems at an early stage when there is a greater chance to prevent illness and preserve health. St. Jude researchers are also looking at methods to educate and empower survivors so that they get the screenings.

The CCSS study and other survivorship studies, including those by St. Jude, lend credence to the idea that accelerated aging is a possible explanation for why some childhood cancer survivors develop chronic health problems decades earlier than their siblings.

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