ArticleCancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology2025
Health Outcomes in Childhood Cancer Survivors with Congenital Anomalies in the Childhood Cancer Survivor Study.
Article in Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundCongenital anomalies are associated with an increased risk of childhood cancer. However, there is a knowledge gap about health outcomes for childhood cancer survivors with congenital anomalies.
methodsWe included childhood cancer survivors from the Childhood Cancer Survivor Study (n = 22,247), comparing survivors with and without self-reported anomalies. Using Cox regression, we estimated HR and 95% confidence intervals (CI) of chronic health conditions (CHC) classified per the Common Terminology Criteria for Adverse Events from 1 (mild) to 5 (fatal) and subsequent malignant neoplasms (SMN), comparing survivors by anomaly status. We calculated age-, sex-, and calendar year-specific mortality rates and standardized mortality ratios for survivors compared with the US population.
resultsAmong survivors, 16.9% (n = 3,880) reported a congenital anomaly. Survivors with anomalies had a higher rate of any CHC (grades 1-5: HR, 1.24; 95% CI, 1.18-1.31), severe CHCs (grades 3-5: HR, 1.29; 95% CI, 1.19-1.40), and multiple CHCs of any grade (≥2 CHCs: HR, 1.31; 95% CI, 1.24-1.39; ≥3 CHCs: HR, 1.42; 95% CI, 1.33-1.52). Survivors with anomalies had an increased rate of soft-tissue sarcomas (HR, 1.96; 95% CI, 1.12-3.44). For deaths related to the original cancer diagnosis, survivors with anomalies (compared with those with no anomalies) had a lower mortality rate (0.64 vs. 0.90 per 1,000 person-years).
conclusionsWe identified an increased rate of CHCs and SMNs among childhood cancer survivors with anomalies and lower mortality directly related to the cancer diagnosis. IMPACT: Future work will focus on the evaluation of genetic pathways that increase the risk of CHCs and SMNs.
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