Falling risk of heart disease among survivors of child cancer since the 1970s

▴ child cancer
Efforts to reduce exposure to the most toxic effects of treatment seem to be working

There has been a measurable decline in serious heart conditions among adult survivors of childhood cancer since the 1970s, finds a study in The BMJ today.

The findings suggest that efforts to reduce exposure to the most toxic effects of anticancer treatment, including radiotherapy, seem to be working.

Many adult survivors of childhood cancer are at risk of early death and long term health conditions related to treatment. For example, cardiac radiation can cause heart and circulatory problems in later life.

In recent years, cancer therapy has focused on improving cure rates while trying to minimise long term adverse effects, but the impact of these changes in survivors is not clear.

To fill this evidence gap, US researchers set out to assess whether these changes are associated with altered risks for cardiac events among adult survivors.

Their findings are based on more than 23,000 adults from the Childhood Cancer Survivor Study who had survived the most common childhood cancers, diagnosed before age 21 and treated in the 1970s, 1980s and 1990s.

Using questionnaires, five cardiac conditions - heart failure, coronary artery disease (narrowing of arteries), heart valve defects (valvular disease), damage to the heart tissue lining (pericardial disease) and heart rhythm problems (arrhythmias) - were recorded.

Cardiovascular risk factors, such as diabetes, high blood pressure and cholesterol levels, smoking, exercise and weight, were also recorded.

The number of survivors exposed to cardiotoxic chemotherapy increased in more recent decades, but the proportion receiving higher doses decreased. Exposure to cardiac radiation declined from 77% of survivors treated in the 1970s to 40% treated in the 1990s.

After taking account of potentially influential factors, risk of coronary artery disease decreased significantly from 0.38% in the 1970s to 0.24% in the 1980s and 0.19% in the 1990s. This was largely due to a strong decline among survivors of Hodgkin lymphoma.

The results also suggest a decline in the risk of heart failure among patients treated in the 1990s, although it was not statistically significant. Risk of other cardiac outcomes remained unchanged.

Traditional cardiovascular risk factors high cholesterol and blood pressure also strongly increased the risk for most cardiac conditions, providing important insights to help improve outcomes for cancer survivors, note the authors.

This is an observational study, so can’t establish cause, added to which it relied on self-reported cardiac outcomes, and almost a third of eligible survivors chose not to participate, thus potentially affecting the results.

However, the researchers suggest that historical reductions in radiotherapy exposure appear to account for some of the declines in coronary artery disease, particularly among survivors of Hodgkin lymphoma.

“These results suggest that efforts to modify cancer therapies in children and promote health surveillance for survivors are beginning to show benefits not only in overall survival but also in late adverse cardiac effects,” they conclude.

Survivorship issues are extremely important to patients, their families, and their doctors, say Mike Hawkins at the University of Birmingham and colleagues in a linked editorial.

This study adds to a growing evidence base that efforts to reduce the cardiotoxicity of treatments seem to be working, they write.

Clear and consistent guidance about clinic follow-up after childhood cancer is also required, they say, and is being produced by the International Late Effects of Childhood Cancer Guideline Harmonization Group.

Tags : #childcancersurvivors #lessheartproblem #bmjstudy #childcancer #medicircle

Related Stories

Loading Please wait...

-Advertisements-




Trending Now

The Double-Edged Sword of Kala-azar Treatment: Shedding Light on Eye ComplicationsMarch 28, 2024
FTCCI Launches Industry-Academia Connect to improve the employability of Engineering Graduates and address the growing demand for Talent in Emerging TechMarch 27, 2024
NTT and Olympus Begin World's First Joint Demonstration Experiment of Cloud Endoscopy SystemMarch 27, 2024
NTT and Olympus Begin World's First Joint Demonstration Experiment of Cloud Endoscopy SystemMarch 27, 2024
2nd Edition of IIFL JITO Ahimsa Run for peace & for non-violence to be held on 31st MarchMarch 27, 2024
Brij Hotels Announced 4 Million in Series A Funding March 27, 2024
Combatting Childhood Sedentariness: The Key to Preventing Premature Vascular DamageMarch 27, 2024
Crucial Findings: Unlocking Paths to Combat Ebola's DevastationMarch 27, 2024
Guarding Against Disease: The Crucial Role of Oral Hygiene in Preventive HealthcareMarch 27, 2024
Sanofi & Cipla announce exclusive distribution partnership to expand reach of CNS portfolio in IndiaMarch 26, 2024
Surmandal's Tribute to the Legends of Hindustani Classical MusicMarch 26, 2024
In Moscow, over 350,000 mammograms have been analyzed using artificial intelligence as part of the compulsory health insurance programMarch 26, 2024
Embark on a Creative Journey: "Kala For A Cause" Unveils Pottery Workshop Series March 26, 2024
Healthtech pioneer Aurora Innovation appoints new CEO – expands in Europe with service that streamlines patient-healthcare interactionMarch 26, 2024
In A Rare Feat, 45 YO Woman Walks Within 6 Hrs. Of Dual Robotic Surgery In A Single Operation At HCGMCCMarch 26, 2024
Improve Cancer Care through Automated CT Analysis: Oncoshield – CTMarch 26, 2024
Empowering Patients: The Role of Advocacy in Indian HealthcareMarch 26, 2024
A New Dawn in Heart Surgery: Mitral Valve Repair for 15-Year-Old PatientMarch 26, 2024
Cracking the Code of Extended Fasting: Lessons from a Comprehensive InvestigationMarch 26, 2024
From Lab to Life: Exploring Eating Behaviors with AI WearablesMarch 26, 2024