Infections among long-term survivors of childhood and adolescent cancer: A report from the Childhood Cancer Survivor Study
Version of Record online: 13 MAY 2014
© 2014 American Cancer Society
Volume 120, Issue 16, pages 2514–2521, August 15, 2014
How to Cite
Perkins, J. L., Chen, Y., Harris, A., Diller, L., Stovall, M., Armstrong, G. T., Yasui, Y., Robison, L. L., Sklar, C. A. and on behalf of the Childhood Cancer Survivor Study (2014), Infections among long-term survivors of childhood and adolescent cancer: A report from the Childhood Cancer Survivor Study. Cancer, 120: 2514–2521. doi: 10.1002/cncr.28763
- Issue online: 5 AUG 2014
- Version of Record online: 13 MAY 2014
- Manuscript Accepted: 25 FEB 2014
- Manuscript Revised: 21 FEB 2014
- Manuscript Received: 12 DEC 2013
- childhood cancer;
- adolescent cancer;
- late effects;
Little is known about infections among adult survivors of childhood cancer. The authors report the occurrence of infections and risk factors for infections in a large cohort of survivors of childhood cancer.
The Childhood Cancer Survivor Study cohort was used to compare incidence rates of infections among 12,360 5-year survivors of childhood cancer with the rates of 4023 siblings. Infection-related mortality of survivors was compared with that of the US population. Demographic and treatment variables were analyzed using Poisson regression to determine the rate ratios (RRs) and corresponding 95% confidence intervals (CIs) for associations with infectious complications.
Compared with the US population, survivors were at an increased risk of death from infectious causes (standardized mortality ratio [SMR], 4.2; 95% CI, 3.2-5.4), with the greatest risk observed among females (SMR, 3.2; 95% CI, 1.5-6.9) and among those who had been exposed to total body irradiation (SMR, 7.8; 95% CI, 1.8-33.0). Survivors also reported higher rates than siblings of overall infectious complications (RR, 1.3; 95% CI, 1.2-1.4) and higher rates of all categories of infection.
Survivors of childhood cancer remain at elevated risk for developing infectious-related complications, and they have a higher risk of infection-related mortality years after therapy. Further investigation is needed to provide insight into the mechanisms for the observed excess risks. Cancer 2014;120:2514–2521. © 2014 American Cancer Society.