Childhood Cancer Survivors at Risk for Heart Disease and Stroke

Survivors of childhood cancer could be up to 20 times more likely to develop ischemic heart disease or to have strokes than their siblings. To determine their level of risk, researchers used a prediction model that included factors like gender, type of chemotherapy, and radiotherapy exposure to the head, neck, or chest.

Adults who have survived childhood cancers have a higher risk of other health complications later on in life, including heart disease and stroke. A team of researchers led by Eric Chow, MD from Seattle Children’s Hospital analyzed data from the Childhood Cancer Survivor Study (CCSS) of 13,060 children who were observed through age 50 for the development of ischemic heart disease and stroke. Their 4,023 siblings were used to establish the baseline population risk in order to predict the risk of ischemic heart disease and stroke in 5-year survivors of childhood cancer.

Ischemic heart disease occurred in 265 childhood cancer survivors in the CCSS database and 295 CCSS experienced a stroke. Risk scores were based on a prediction model that included gender, type of chemotherapy, and radiotherapy exposure to the head, neck, or chest. Risk scores were categorized as low-, moderate-, and high-risk. The cumulative incidences of heart disease or stroke at age 50 among CCSS low-risk groups were < 5%, compared with approximately 20% for high-risk groups. The cumulative incidence was only 1% for siblings. The researchers concluded that this model may be useful to predict heart disease and stroke among childhood cancer survivors with reasonable accuracy.

Study findings are available at http://ascopubs.org/doi/abs/10.1200/JCO.2017.74.8673.