Coronary Artery Disease Risk Down in Survivors of Childhood Cancer

There has been a decrease in the risk for coronary artery disease among adult survivors of childhood cancer, according to a study published online January in The BMJ.

Daniel A. Mulrooney, M.D., from St. Jude Children's Research Hospital in Memphis, Tennessee, and colleagues conducted a retrospective cohort study at 27 institutions involving 23,462 five-year survivors (26.4, 39.9, and 33.6 percent treated in the 1970s, 1980s, and 1990s, respectively). Participants had been diagnosed with leukemia, brain cancer, Hodgkin lymphoma, non-Hodgkin lymphoma, renal tumors, neuroblastoma, soft tissue sarcomas, and bone sarcomas before age 21 years.

The researchers found that in most recent eras, there was a decrease in the 20-year cumulative incidence of heart failure (0.69, 0.74, and 0.54 percent for those treated in the 1970s, 1980s, and 1990s, respectively) and coronary artery disease (0.38, 0.24, and 0.19 percent, respectively). The risk for heart failure, coronary artery disease, and valvular heart disease decreased for survivors with a diagnosis in the 1980s and 1990s versus the 1970s, with the decrease only significant for coronary artery disease (hazard ratios, 0.65 and 0.53, respectively). The overall risk for coronary artery disease was attenuated after adjustment for cardiac radiation, especially for survivors of Hodgkin lymphoma.

"Efforts to modify cancer therapies in children and promote health surveillance for survivors are beginning to show benefits not only in overall survival but also in late adverse cardiac effects," the authors write.

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