TOPLINE:

Adolescent and young adult cancer survivors vs matched control individuals showed a 39% vs 26% cumulative incidence of chronic medical conditions at 10 years post-diagnosis. The risk doubles for any medical condition and increases 2.3-fold for multiple conditions, with the highest risk among hematologic cancer survivors and those with distant-stage disease.

METHODOLOGY:

• Increasing cancer incidence and improved survival rates among adolescents and young adults diagnosed with cancer have led to a growing population of cancer survivors.
• Researchers conducted a retrospective cohort study involving 14,917 2-year survivors of 11 common adolescent and young adult cancers diagnosed at Kaiser Permanente Southern and Northern California during 2006-2020, matched with 149,164 individuals without cancer in a 1:10 ratio by age, sex, calendar year, and site.
• Analysis included calculation of cumulative incidence accounting for death as a competing risk.
• Investigators utilized Poisson regression to estimate the incidence rate ratio (IRR) of each condition in cancer survivors vs matched control individuals, adjusting for age, sex, and race or ethnicity.
• Results showed the highest 5-year cumulative incidence of thyroid (17.4%), respiratory (6.6%), cardiovascular (5.0%), and liver (4.8%) diseases.

TAKEAWAY:

• The 10-year cumulative incidence of any medical condition was 39% in survivors vs 26% in matched control individuals.
• Survivors demonstrated a doubled risk for being diagnosed with any medical condition (IRR, 2.0; 95% CI, 1.9-2.0) and an even higher risk for two or more conditions (IRR, 2.3; 95% CI, 2.2-2.5).
• Analysis revealed the highest risk among survivors of hematologic cancers and those diagnosed with distant-stage disease.
• Elevated risks were consistently observed across all sociodemographic groups in this insured population.

IN PRACTICE:

“Our results highlight the high burden of numerous chronic medical conditions, information that is important for survivorship care planning that includes prevention, early diagnosis, and interventions to minimize the impact of these conditions,” wrote the authors of the study.

SOURCE:

The study was led by Theresa H.M. Keegan, PhD, MS, Division of Hematology and Oncology, Center for Oncology Hematology Outcomes Research and Training, University of California Davis Comprehensive Cancer Center, Sacramento, California, and Kaiser Permanente Washington Health Research Institute in Seattle. It was published online in Cancer.

LIMITATIONS:

Cancer survivors may have experienced increased healthcare interactions beyond 2 years post-diagnosis, potentially leading to higher surveillance and diagnosis rates of medical conditions. While the study focused on largely symptomatic diseases requiring medical management to minimize this bias, the findings may have limited generalizability because all participants had health insurance through Kaiser Permanente, potentially providing better access to preventive services. The median follow-up time of 6 years limits the ability to capture late effects with longer latency periods. Additionally, the use of International Classification of Diseases 9/10 and Current Procedural Terminology codes could have resulted in misclassification of chronic medical conditions, though this would likely affect both cancer survivors and the comparison population similarly.

DISCLOSURES:

The study was supported by grant P01CA233432 from the National Cancer Institute, including a 3P01CA233432‐05S1 supplement. Chun Chao, PhD, MS, disclosed receiving grant funding from the American Cancer Society. Jessica Chubak, PhD; Erin E. Hahn, PhD, MPH; Lawrence H. Kushi, ScD; Hazel B. Nichols, PhD; Charles Quesenberry, PhD; and Kathryn J. Ruddy, MD, MPH, reported receiving grant funding from the National Institutes of Health or National Cancer Institute.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.