Risk and impact of pulmonary complications in survivors of childhood cancer: A report from the Childhood Cancer Survivor Study

Andrew C. Dietz, Yan Chen, Yutaka Yasui, Kirsten K. Ness, James S. Hagood, Eric J. Chow, Marilyn Stovall, Joseph P. Neglia, Kevin C. Oeffinger, Ann C. Mertens, Leslie L. Robison, Gregory T. Armstrong, Daniel A. Mulrooney

Research output: Contribution to journalArticle

17 Citations (Scopus)

Abstract

BACKGROUND: Pulmonary complications after cancer therapy are varied. This study describes pulmonary outcomes among childhood cancer survivors and evaluates their impact on daily activities. METHODS: The incidence of pulmonary outcomes (asthma, chronic cough, emphysema, lung fibrosis, oxygen need, and recurrent pneumonia) reported among 5-year cancer survivors (n = 14,316) and the incidence of death due to pulmonary causes among all eligible survivors (n = 20,690) in the Childhood Cancer Survivor Study were compared with those for sibling controls (n = 4027) with cumulative incidence, standardized mortality ratio (SMR), and piecewise exponential models. Logistic regression with random effects was used to estimate odds ratios (ORs) and 95% confidence intervals (CIs) for activity limitations with pulmonary complications. RESULTS: By the age of 45 years, the cumulative incidence of any pulmonary condition was 29.6% (95% CI, 29.1%-30.0%) for cancer survivors and 26.5% (95% CI, 24.9%-28.0%) for siblings. Fewer survivors reported ever smoking (23.6% vs 36.4%, P <.001), but survivors were more likely to report chronic cough (rate ratio [RR], 1.6; 95% CI, 1.4-1.9), oxygen need (RR, 1.8; 95% CI, 1.5-2.2), lung fibrosis (RR, 3.5; 95% CI, 2.3-5.4), and recurrent pneumonia (RR, 2.0; 95% CI, 1.4-3.0). The SMR for death due to pulmonary causes was 5.9 (95% CI, 4.2-8.1), and it was associated with platinum exposure and lung radiation (P <.01). The impact of chronic cough on daily activities for survivors (OR vs survivors without chronic cough, 2.7) was greater than that for siblings (OR, 2.0; P =.04). CONCLUSIONS: Pulmonary complications are substantial among adult survivors of childhood cancer and can affect daily activities. Cancer 2016;122:3687-96.

Original languageEnglish (US)
Pages (from-to)3687-3696
Number of pages10
JournalCancer
Volume122
Issue number23
DOIs
StatePublished - Dec 1 2016

Fingerprint

Survivors
Lung
Confidence Intervals
Neoplasms
Cough
Siblings
Odds Ratio
Incidence
Pneumonia
Fibrosis
Oxygen
Mortality
Emphysema
Platinum
Asthma
Logistic Models
Smoking

Keywords

  • cancer treatment
  • childhood cancer
  • late effects
  • pulmonary toxicity
  • survivorship

Cite this

Dietz, A. C., Chen, Y., Yasui, Y., Ness, K. K., Hagood, J. S., Chow, E. J., ... Mulrooney, D. A. (2016). Risk and impact of pulmonary complications in survivors of childhood cancer: A report from the Childhood Cancer Survivor Study. Cancer, 122(23), 3687-3696. https://doi.org/10.1002/cncr.30200

Risk and impact of pulmonary complications in survivors of childhood cancer : A report from the Childhood Cancer Survivor Study. / Dietz, Andrew C.; Chen, Yan; Yasui, Yutaka; Ness, Kirsten K.; Hagood, James S.; Chow, Eric J.; Stovall, Marilyn; Neglia, Joseph P.; Oeffinger, Kevin C.; Mertens, Ann C.; Robison, Leslie L.; Armstrong, Gregory T.; Mulrooney, Daniel A.

In: Cancer, Vol. 122, No. 23, 01.12.2016, p. 3687-3696.

Research output: Contribution to journalArticle

Dietz, AC, Chen, Y, Yasui, Y, Ness, KK, Hagood, JS, Chow, EJ, Stovall, M, Neglia, JP, Oeffinger, KC, Mertens, AC, Robison, LL, Armstrong, GT & Mulrooney, DA 2016, 'Risk and impact of pulmonary complications in survivors of childhood cancer: A report from the Childhood Cancer Survivor Study', Cancer, vol. 122, no. 23, pp. 3687-3696. https://doi.org/10.1002/cncr.30200
Dietz, Andrew C. ; Chen, Yan ; Yasui, Yutaka ; Ness, Kirsten K. ; Hagood, James S. ; Chow, Eric J. ; Stovall, Marilyn ; Neglia, Joseph P. ; Oeffinger, Kevin C. ; Mertens, Ann C. ; Robison, Leslie L. ; Armstrong, Gregory T. ; Mulrooney, Daniel A. / Risk and impact of pulmonary complications in survivors of childhood cancer : A report from the Childhood Cancer Survivor Study. In: Cancer. 2016 ; Vol. 122, No. 23. pp. 3687-3696.
@article{8c8fdf4f07bf40419a2d3e091f0cfe70,
title = "Risk and impact of pulmonary complications in survivors of childhood cancer: A report from the Childhood Cancer Survivor Study",
abstract = "BACKGROUND: Pulmonary complications after cancer therapy are varied. This study describes pulmonary outcomes among childhood cancer survivors and evaluates their impact on daily activities. METHODS: The incidence of pulmonary outcomes (asthma, chronic cough, emphysema, lung fibrosis, oxygen need, and recurrent pneumonia) reported among 5-year cancer survivors (n = 14,316) and the incidence of death due to pulmonary causes among all eligible survivors (n = 20,690) in the Childhood Cancer Survivor Study were compared with those for sibling controls (n = 4027) with cumulative incidence, standardized mortality ratio (SMR), and piecewise exponential models. Logistic regression with random effects was used to estimate odds ratios (ORs) and 95{\%} confidence intervals (CIs) for activity limitations with pulmonary complications. RESULTS: By the age of 45 years, the cumulative incidence of any pulmonary condition was 29.6{\%} (95{\%} CI, 29.1{\%}-30.0{\%}) for cancer survivors and 26.5{\%} (95{\%} CI, 24.9{\%}-28.0{\%}) for siblings. Fewer survivors reported ever smoking (23.6{\%} vs 36.4{\%}, P <.001), but survivors were more likely to report chronic cough (rate ratio [RR], 1.6; 95{\%} CI, 1.4-1.9), oxygen need (RR, 1.8; 95{\%} CI, 1.5-2.2), lung fibrosis (RR, 3.5; 95{\%} CI, 2.3-5.4), and recurrent pneumonia (RR, 2.0; 95{\%} CI, 1.4-3.0). The SMR for death due to pulmonary causes was 5.9 (95{\%} CI, 4.2-8.1), and it was associated with platinum exposure and lung radiation (P <.01). The impact of chronic cough on daily activities for survivors (OR vs survivors without chronic cough, 2.7) was greater than that for siblings (OR, 2.0; P =.04). CONCLUSIONS: Pulmonary complications are substantial among adult survivors of childhood cancer and can affect daily activities. Cancer 2016;122:3687-96.",
keywords = "cancer treatment, childhood cancer, late effects, pulmonary toxicity, survivorship",
author = "Dietz, {Andrew C.} and Yan Chen and Yutaka Yasui and Ness, {Kirsten K.} and Hagood, {James S.} and Chow, {Eric J.} and Marilyn Stovall and Neglia, {Joseph P.} and Oeffinger, {Kevin C.} and Mertens, {Ann C.} and Robison, {Leslie L.} and Armstrong, {Gregory T.} and Mulrooney, {Daniel A.}",
year = "2016",
month = "12",
day = "1",
doi = "10.1002/cncr.30200",
language = "English (US)",
volume = "122",
pages = "3687--3696",
journal = "Cancer",
issn = "0008-543X",
publisher = "John Wiley and Sons Inc.",
number = "23",

}

TY - JOUR

T1 - Risk and impact of pulmonary complications in survivors of childhood cancer

T2 - A report from the Childhood Cancer Survivor Study

AU - Dietz, Andrew C.

AU - Chen, Yan

AU - Yasui, Yutaka

AU - Ness, Kirsten K.

AU - Hagood, James S.

AU - Chow, Eric J.

AU - Stovall, Marilyn

AU - Neglia, Joseph P.

AU - Oeffinger, Kevin C.

AU - Mertens, Ann C.

AU - Robison, Leslie L.

AU - Armstrong, Gregory T.

AU - Mulrooney, Daniel A.

PY - 2016/12/1

Y1 - 2016/12/1

N2 - BACKGROUND: Pulmonary complications after cancer therapy are varied. This study describes pulmonary outcomes among childhood cancer survivors and evaluates their impact on daily activities. METHODS: The incidence of pulmonary outcomes (asthma, chronic cough, emphysema, lung fibrosis, oxygen need, and recurrent pneumonia) reported among 5-year cancer survivors (n = 14,316) and the incidence of death due to pulmonary causes among all eligible survivors (n = 20,690) in the Childhood Cancer Survivor Study were compared with those for sibling controls (n = 4027) with cumulative incidence, standardized mortality ratio (SMR), and piecewise exponential models. Logistic regression with random effects was used to estimate odds ratios (ORs) and 95% confidence intervals (CIs) for activity limitations with pulmonary complications. RESULTS: By the age of 45 years, the cumulative incidence of any pulmonary condition was 29.6% (95% CI, 29.1%-30.0%) for cancer survivors and 26.5% (95% CI, 24.9%-28.0%) for siblings. Fewer survivors reported ever smoking (23.6% vs 36.4%, P <.001), but survivors were more likely to report chronic cough (rate ratio [RR], 1.6; 95% CI, 1.4-1.9), oxygen need (RR, 1.8; 95% CI, 1.5-2.2), lung fibrosis (RR, 3.5; 95% CI, 2.3-5.4), and recurrent pneumonia (RR, 2.0; 95% CI, 1.4-3.0). The SMR for death due to pulmonary causes was 5.9 (95% CI, 4.2-8.1), and it was associated with platinum exposure and lung radiation (P <.01). The impact of chronic cough on daily activities for survivors (OR vs survivors without chronic cough, 2.7) was greater than that for siblings (OR, 2.0; P =.04). CONCLUSIONS: Pulmonary complications are substantial among adult survivors of childhood cancer and can affect daily activities. Cancer 2016;122:3687-96.

AB - BACKGROUND: Pulmonary complications after cancer therapy are varied. This study describes pulmonary outcomes among childhood cancer survivors and evaluates their impact on daily activities. METHODS: The incidence of pulmonary outcomes (asthma, chronic cough, emphysema, lung fibrosis, oxygen need, and recurrent pneumonia) reported among 5-year cancer survivors (n = 14,316) and the incidence of death due to pulmonary causes among all eligible survivors (n = 20,690) in the Childhood Cancer Survivor Study were compared with those for sibling controls (n = 4027) with cumulative incidence, standardized mortality ratio (SMR), and piecewise exponential models. Logistic regression with random effects was used to estimate odds ratios (ORs) and 95% confidence intervals (CIs) for activity limitations with pulmonary complications. RESULTS: By the age of 45 years, the cumulative incidence of any pulmonary condition was 29.6% (95% CI, 29.1%-30.0%) for cancer survivors and 26.5% (95% CI, 24.9%-28.0%) for siblings. Fewer survivors reported ever smoking (23.6% vs 36.4%, P <.001), but survivors were more likely to report chronic cough (rate ratio [RR], 1.6; 95% CI, 1.4-1.9), oxygen need (RR, 1.8; 95% CI, 1.5-2.2), lung fibrosis (RR, 3.5; 95% CI, 2.3-5.4), and recurrent pneumonia (RR, 2.0; 95% CI, 1.4-3.0). The SMR for death due to pulmonary causes was 5.9 (95% CI, 4.2-8.1), and it was associated with platinum exposure and lung radiation (P <.01). The impact of chronic cough on daily activities for survivors (OR vs survivors without chronic cough, 2.7) was greater than that for siblings (OR, 2.0; P =.04). CONCLUSIONS: Pulmonary complications are substantial among adult survivors of childhood cancer and can affect daily activities. Cancer 2016;122:3687-96.

KW - cancer treatment

KW - childhood cancer

KW - late effects

KW - pulmonary toxicity

KW - survivorship

UR - http://www.scopus.com/inward/record.url?scp=84994251918&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84994251918&partnerID=8YFLogxK

U2 - 10.1002/cncr.30200

DO - 10.1002/cncr.30200

M3 - Article

C2 - 27504874

AN - SCOPUS:84994251918

VL - 122

SP - 3687

EP - 3696

JO - Cancer

JF - Cancer

SN - 0008-543X

IS - 23

ER -