Accelerated Aging in Childhood Cancer Survivors – Center for Health Decision Science

CHDS faculty Jennifer Yeh and Zachary Ward and colleagues published a study in JAMA Oncology revealing that adult survivors of childhood cancer experience earlier onset and a higher lifetime risk of select chronic health conditions compared to the general population. Despite major advances in childhood cancer treatment and survival, the long-term impact of these treatments on aging-related health among 5-year survivors remains unclear.

Using data from the Childhood Cancer Survivor Study, the research team developed the Cancer Outcomes Microsimulation: Pediatric and Adolescent SurvivorShip (COMPASS) model to project long-term health outcomes in 5-year survivors diagnosed between 1970 and 1999. By incorporating additional data from the Surveillance, Epidemiology, and End Results (SEER) Program and other population-based sources, the model estimated the risk of developing at least one of eight chronic health conditions—including six aging-related conditions (breast cancer, colorectal cancer, heart failure, myocardial infarction/coronary artery disease, valvular disease, and stroke) and two life-threatening secondary cancers common among survivors (sarcomas and glial tumors). Estimates were compared to age-, sex-, and calendar year–matched individuals representative of the general population.

The findings are striking: childhood cancer survivors were projected to develop their first chronic condition 17.7 years earlier, with a 2.7-fold higher relative risk and a 34.2% excess risk by age 65, compared with the general population. Risks were even higher among those who received radiation therapy, with projected disease onset 22 years earlier and a 37.3% excess risk. Notably, even survivors who did not receive radiation faced significantly elevated risks—13.5 years earlier onset and a 31.0% excess risk—underscoring that all survivors, regardless of radiation exposure, are projected to experience accelerated aging.

These findings highlight the need for lifelong, coordinated care for all childhood cancer survivors, starting decades earlier than in the general population, regardless of diagnosis or treatment history.

Learn more: Read the JAMA Oncology article, Accelerated Aging in Survivors of Childhood Cancer – Early Onset and Excess Risk of Chronic Conditions
Learn more: Listen to the JAMA author interviews podcast, Accelerated Aging in Survivors of Childhood Cancer