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Skeletal adverse events in childhood cancer survivors: An Adult Life after Childhood Cancer in Scandinavia cohort study

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Title: Skeletal adverse events in childhood cancer survivors: An Adult Life after Childhood Cancer in Scandinavia cohort study
Authors: Scott Montgomery, Jeanette Falck Winther, Cecilia Petersen, Laura Madanat-Harjuoja, Anna Sällfors Holmqvist, Laufey Tryggvadottir, Andrea Bautz, Trausti Oskarsson, Arja Harila-Saari, Henrik Hasle, Anne Katrine Duun-Henriksen, Riitta Niinimäki, Mats Heyman
Source: Oskarsson, T, Duun-Henriksen, A K, Bautz, A, Montgomery, S, Harila-Saari, A, Petersen, C, Niinimäki, R, Madanat-Harjuoja, L, Tryggvadóttir, L, Holmqvist, A S, Hasle, H, Heyman, M, Winther, J F & ALiCCS Study Group 2021, 'Skeletal adverse events in childhood cancer survivors : An Adult Life after Childhood Cancer in Scandinavia cohort study', International Journal of Cancer, vol. 149, no. 11, pp. 1863-1876. https://doi.org/10.1002/ijc.33741
Publisher Information: Wiley, 2021.
Publication Year: 2021
Subject Terms: skeletal adverse events, Male, Risk, Adolescent, OSTEONECROSIS, CHILDREN, Bone Diseases/epidemiology, Scandinavian and Nordic Countries, Cohort Studies, Fractures, Bone, Young Adult, 03 medical and health sciences, 0302 clinical medicine, FRACTURES, Cancer Survivors, Neoplasms, YOUNG-ADULTS, LYMPHOMA, childhood cancer, late effects, Humans, Registries, Child, ACUTE LYMPHOBLASTIC-LEUKEMIA, Hospitalization/statistics & numerical data, Cancer och onkologi, PEDIATRIC-PATIENTS, LONG-TERM SURVIVORS, Registries/statistics & numerical data, Infant, Scandinavian and Nordic Countries/epidemiology, 3. Good health, Hospitalization, Cancer and Oncology, Child, Preschool, Fractures, Bone/epidemiology, RISK-FACTORS, Female, BONE-MINERAL DENSITY, Bone Diseases, ALiCCS, survivorship, Neoplasms/epidemiology, Cancer Survivors/statistics & numerical data
Description: The dynamic growth of the skeleton during childhood and adolescence renders it vulnerable to adverse effects of cancer treatment. The lifetime risk and patterns of skeletal morbidity have not been described in a population‐based cohort of childhood cancer survivors. A cohort of 26 334 1‐year cancer survivors diagnosed before 20 years of age was identified from the national cancer registries of Denmark, Finland, Iceland and Sweden as well as a cohort of 127 531 age‐ and sex‐matched comparison subjects randomly selected from the national population registries in each country. The two cohorts were linked with data from the national hospital registries and the observed numbers of first‐time hospital admissions for adverse skeletal outcomes among childhood cancer survivors were compared to the expected numbers derived from the comparison cohort. In total, 1987 childhood cancer survivors had at least one hospital admission with a skeletal adverse event as discharge diagnosis, yielding a rate ratio (RR) of 1.35 (95% confidence interval, 1.29‐1.42). Among the survivors, we observed an increased risk for osteonecrosis with a RR of 25.9 (15.0‐44.5), osteoporosis, RR 4.53 (3.28‐6.27), fractures, RR 1.27 (1.20‐1.34), osteochondropathies, RR 1.57 (1.28‐1.92) and osteoarthrosis, RR 1.48 (1.28‐1.72). The hospitalization risk for any skeletal adverse event was higher among survivors up to the age of 60 years, but the lifetime pattern was different for each type of skeletal adverse event. Understanding the different lifetime patterns and identification of high‐risk groups is crucial for developing strategies to optimize skeletal health in childhood cancer survivors.
Document Type: Article
File Description: application/pdf
Language: English
ISSN: 1097-0215
0020-7136
DOI: 10.1002/ijc.33741
DOI: 10.1530/ey.19.9.16
Access URL: https://onlinelibrary.wiley.com/doi/pdfdirect/10.1002/ijc.33741
https://pubmed.ncbi.nlm.nih.gov/34278568
https://www.ncbi.nlm.nih.gov/pubmed/34278568
https://helda.helsinki.fi/handle/10138/336556
https://onlinelibrary.wiley.com/doi/10.1002/ijc.33741
https://lup.lub.lu.se/search/publication/a4dfab86-e910-4130-96af-8706c82378a5
https://pubmed.ncbi.nlm.nih.gov/34278568/
https://pure.au.dk/ws/files/274237614/Intl_Journal_of_Cancer_2021_Oskarsson_Skeletal_adverse_events_in_childhood_cancer_survivors_An_Adult_Life_after.pdf
http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-457651
https://pure.au.dk/ws/files/274237614/Intl_Journal_of_Cancer_2021_Oskarsson_Skeletal_adverse_events_in_childhood_cancer_survivors_An_Adult_Life_after.pdf
https://doi.org/10.1002/ijc.33741
https://pure.au.dk/portal/en/publications/fc7d292f-dc22-4155-b2a3-95d84bc49a4b
http://www.scopus.com/inward/record.url?scp=85111998976&partnerID=8YFLogxK
Rights: CC BY NC ND
Accession Number: edsair.doi.dedup.....b03d585c47d6c34ac9471b14aaca9fe5
Database: OpenAIRE
Description
Abstract:The dynamic growth of the skeleton during childhood and adolescence renders it vulnerable to adverse effects of cancer treatment. The lifetime risk and patterns of skeletal morbidity have not been described in a population‐based cohort of childhood cancer survivors. A cohort of 26 334 1‐year cancer survivors diagnosed before 20 years of age was identified from the national cancer registries of Denmark, Finland, Iceland and Sweden as well as a cohort of 127 531 age‐ and sex‐matched comparison subjects randomly selected from the national population registries in each country. The two cohorts were linked with data from the national hospital registries and the observed numbers of first‐time hospital admissions for adverse skeletal outcomes among childhood cancer survivors were compared to the expected numbers derived from the comparison cohort. In total, 1987 childhood cancer survivors had at least one hospital admission with a skeletal adverse event as discharge diagnosis, yielding a rate ratio (RR) of 1.35 (95% confidence interval, 1.29‐1.42). Among the survivors, we observed an increased risk for osteonecrosis with a RR of 25.9 (15.0‐44.5), osteoporosis, RR 4.53 (3.28‐6.27), fractures, RR 1.27 (1.20‐1.34), osteochondropathies, RR 1.57 (1.28‐1.92) and osteoarthrosis, RR 1.48 (1.28‐1.72). The hospitalization risk for any skeletal adverse event was higher among survivors up to the age of 60 years, but the lifetime pattern was different for each type of skeletal adverse event. Understanding the different lifetime patterns and identification of high‐risk groups is crucial for developing strategies to optimize skeletal health in childhood cancer survivors.
ISSN:10970215
00207136
DOI:10.1002/ijc.33741