Table 3.
Chronic health conditions among early-AYAs, childhood cancer survivors, and siblings according to CTCAE severity grade.
| Organ System | Early-AYA Survivors (n=4082) | Childhood Survivors (n=4082) | Siblings (n=3806) | HR for Early-AYA Survivors (Siblings as referent group) | HR for Childhood Survivors (Siblings as referent group) |
|---|---|---|---|---|---|
| Any Grade 1-5 conditions | |||||
| N (%) | 2637 (64·6%) | 2419 (59·3%) | 1562 (41·0%) | ||
| Cumulative Incidence by age 45 years (95% CI) | 73·0% (70·1 to 75·6) | 87·1% (84·0 to 90·0) | 56·7% (53·6 to 59·6) | ||
| Cumulative Incidence by 30 years post diagnosis (95% CI) | 80·8% (77·8 to 83·9) | 74·5% (71·2 to 77·8) | NA | ||
| HR (95% CI) | 2·2 (2·0 to 2·3) | 2.7 (2.5 to 2.9) | |||
| Any Grade 3-5 conditions | |||||
| N (%) | 1254 (30·7%) | 1044 (25·6%) | 320 (8·4%) | ||
| Cumulative Incidence by age 45 years (95% CI) | 39·4% (36·9 to 42·0) | 56·3% (52·0 to 60·3) | 12·1% (10·5 to 13·8) | ||
| Cumulative Incidence by 30 years post diagnosis (95% CI) | 45·6% (42·8 to 48·5) | 39·6% (36·6 to 42·5) | NA | ||
| HR (95% CI) | 4·2 (3·7 to 4·8) | 5.6 (4.9 to 6.3) | |||
| Grade 3-5 Cardiac | |||||
| N (%) | 464 (11·4%) | 334 (8·2%) | 107 (2·8%) | ||
| Cumulative Incidence by age 45 years (95% CI) | 15·4% (13·8 to 17·0) | 19·9% (17·3 to 22·7) | 4·1% (3·2 to 5·1) | ||
| Cumulative Incidence by 30 years post diagnosis (95% CI) | 19.7% (17.6-21.7) | 13.6% (11.7-15.4) | NA | ||
| HR (95% CI) | 4·3 (3·5 to 5·4) | 5.6 (4.5 to 7.1) | |||
| Grade 3-5 Endocrine | |||||
| N (%) | 244 (6·0%) | 324 (7·9%) | 65 (1·7%) | ||
| Cumulative Incidence by age 45 years (95% CI) | 8·1% (7·0 to 9·3) | 15·3% (13·3 to 17·4) | 2·9% (2·1 to 3·8) | ||
| Cumulative Incidence by 30 years post diagnosis (95% CI) | 8·8% (7·6 to 10·1) | 11·4% (9·9 to 12·9) | NA | ||
| HR (95% CI) | 3·9 (2·9 to 5·1) | 6.4 (5.1-8.0) | |||
| Grade 3-5 Pulmonary | |||||
| N (%) | 66 (1·6%) | 44 (1·1%) | 11 (0·3%) | ||
| Cumulative Incidence by age 45 years (95% CI) | 2·0% (1·5 to 2·6) | 2·8% (1·8 to 4·0) | 0·5% (0·3 to 0·9) | ||
| Cumulative Incidence by 30 years post diagnosis (95% CI) | 2·5% (1·7 to 3·2) | 1·7% (1·0 to 2·3) | NA | ||
| HR (95% CI) | 6·3(3·2 to 12·7) | 7.3(3.6 to 14.9) | |||
| Grade 3-5 Musculoskeletal | |||||
| N (%) | 110 (2·7%) | 80 (2·0%) | 17 (0·4%) | ||
| Cumulative Incidence by age 45 years (95% CI) | 3·4% (2·7 to 4·3) | 3·7% (2·6 to 5·0) | 0·5% (0·3 to 1·0) | ||
| Cumulative Incidence by 30 years post diagnosis (95% CI) | 3·6 % (2·7 to 4·5) | 2·7% (2·0 to 3·4) | NA | ||
| HR (95% CI) | 6·5 (3·9 to 11·1) | 8.0(4.6 to 14.0) | |||
| Grade 3-5 Neurological | |||||
| N (%) | 83 (2·0%) | 77 (1.9%) | 33 (0·9%) | ||
| Cumulative Incidence by age 45 years (95% CI) | 2·4% (1·8 to 3·0) | 3·7% (2·5 to 5·3) | 1·4% (0·9 to 2·0) | ||
| Cumulative Incidence by 30 years post diagnosis (95% CI) | 2·7% (2·0 to 3·4) | 2·4% (1·7 to 3·1) | NA | ||
| HR (95% CI) | 2·2 (1·4 to 3·3) | 3.2 (2.1 to 5.0) |
*
Also includes in situ breast cancers and benign meningioma requiring surgery
Abbreviations: CTCAE, Common Terminology Criteria for Adverse Events; HR, hazard ratio; CI, confidence interval; SMN, subsequent malignant neoplasm.
Elazard ratios adjusted for sex, race/ethnicity. Comparisons between survivors and siblings used age as the time scale and late entry, with survivor entering at an age equivalent to 5 years post diagnosis and siblings age 5 or older.