Does childhood cancer lead to accelerated aging in later life?

Young adults who have survived childhood cancer report an overall health-related quality of life comparable to that of adults in their 40s in the general population. These findings from researchers at the Harvard T.H. Chan School of Public Health and Dana-Farber/Boston Children’s Cancer and Blood Disorders Center (both MA, USA) indicate that childhood cancer has a lasting effect on adult health, prompting further research into how these effects might be combated.

The study, published recently in the Journal of the National Cancer Institute, used the presence or absence of chronic health conditions as the key marker for determining health-related quality of life. Participants aged 18–49 years were taken from the national Childhood Cancer Survivor Study and examined for health indicators.

Childhood cancer survivors have been demonstrated to have a higher risk of developing other cancers, lung disease, heart disease, infertility and other chronic conditions. However, research indicates that this increased risk is largely attributed to their childhood cancer treatment – chemotherapy, radiation and surgery – rather than the cancer itself.

The researchers demonstrated that young adult survivors (aged 18–29 years) reported an average health-related quality of life score of 0.78 on the 0–1 scale, which is equivalent to scores reported by 40–49 year olds in the general population.

Furthermore, survivors with no chronic conditions had an average health-related quality of life score of 0.81 and those with two chronic conditions scored 0.77. Those with three or more disabling, severe, or life-threatening conditions had an average score of 0.70.

Of the young adults who participated in the study, only 20% reported no chronic health conditions. Interestingly, the survivors who reported no chronic health conditions had quality-of-life scores similar to the age-matched general population.

Senior author Lisa Diller (Dana-Farber) commented: “Our findings indicate survivors’ accelerated aging and also help us understand the health-related risks associated with having had cancer as a child. What’s encouraging is that the lower quality of life scores are associated with chronic disease after treatment, not with a history of pediatric cancer itself. If we can prevent treatment-related conditions by changes in the therapy we use for the cancer, then childhood cancer will become an acute, rather than a chronic, illness.”

The study highlights how the pediatric cancer landscape has changed in recent decades: childhood cancer survival has increased significantly since the 1970s, and the methods of treatment have changed alongside this. Going forward, researchers hope to further improve treatment option to reduce their effect on survivors’ later quality of life.

“By enabling comparisons to the general population, our findings provide context to better understand how the cancer experience may influence the long-term well-being of survivors,” added Jennifer Yeh, lead author of the study from the Harvard T.H. Chan School of Public Health. “This is another way to understand the health challenges survivors face and where to focus efforts to improve the long-term health and quality of life of survivors.”

Sources: Yeh J, Hanmer J, Ward Z et al. Chronic conditions and utility-based health-related quality of life in adult childhood cancer survivors. JNCI J Natl Cancer Inst 108 (9): djw046 (2016); Harvard T.H. Chan School of Public Health press release