Burden of Illness in Adult Survivors of Childhood Cancers: Findings from a Population-based National Sample

Background: The number of adult survivors of childhood cancer in the U.S. is increasing due to effective treatments and improved survival. The purpose of this study was to use a national, population-based sample estimate the burden of illness in adult survivors of childhood cancer.

Methods: A total of 410 adult survivors of childhood cancer and 2,050 matched controls were identified from the NHIS (1997-2006). Multiple measures of burden, general health, and lost productivity were compared for the two groups overall and by time since diagnosis.

Results: Adult survivors of childhood cancer reported poorer outcomes across the majority of general health measures and productivity measures compared to matched controls. Survivors were more likely to report their health status as fair or poor (24.2% vs. 9.6%; p<0.001), and spending more than 10 days in bed in the past 12 months (14.3% vs. 5.1%; p<0.001). Survivors were also more likely to report being unable to work due to health problems (16.0% vs. 5.0%; p<0.001) and having more days lost from work in the past 12 months (35.7 days vs. 12.6 days; p<0.001). When stratifying cancer survivors by time since diagnosis, survivors had poorer health outcomes than matched controls across several measures, with the greatest differences less than five years and at least 30 years after diagnosis.

Conclusions: Adult survivors of childhood cancers have poorer health outcomes and more health limitations than similar individuals without cancer. Poorer outcomes were observed in survivors more than thirty years following their diagnosis.