| Title: |
Late-onset Cognitive Impairment and Modifiable Risk Factors in Adult Childhood Cancer Survivors |
| Authors: |
Phillips, Nicholas S.; Stratton, Kayla L.; Williams, AnnaLynn M.; Ahles, Tim; Ness, Kirsten K.; Cohen, Harvey Jay; Edelstein, Kim; Yasui, Yutaka; Oeffinger, Kevin; Chow, Eric J.; Howell, Rebecca M.; Robison, Leslie L.; Armstrong, Gregory T.; Leisenring, Wendy M.; Krull, Kevin R. |
| Source: |
JAMA Network Open ; volume 6, issue 5, page e2316077 ; ISSN 2574-3805 |
| Publisher Information: |
American Medical Association (AMA) |
| Publication Year: |
2023 |
| Description: |
Importance Long-term survivors of childhood cancer may be at elevated risk for new neurocognitive impairment and decline as they age into adulthood. Objective To determine whether aging adult childhood cancer survivors report more new-onset neurocognitive impairments compared with their siblings and to identify risk factors associated with such impairments. Design, Setting, and Participants Participants of this cohort study included adult survivors of childhood cancer from the Childhood Cancer Survivor Study and their siblings as a control group. The original cohort included survivors who received a diagnosis between January 1, 1970, and December 31, 1986, for whom longitudinal neurocognitive assessment was available. This study examined the prevalence of new-onset neurocognitive impairment between baseline (23.4 years after diagnosis) and follow-up (35.0 years after diagnosis). The analysis was performed from January 2021 to May 2022. Exposures Cancer treatment exposures were abstracted from medical records. Chronic health conditions were graded using Common Terminology Criteria for Adverse Events version 4.03. Main Outcomes and Measures The primary outcome was new-onset (present at follow-up, but not present at baseline) neurocognitive impairment (defined as a score in the worst 10% of the sibling cohort). Impairment was assessed using the Childhood Cancer Survivor Study Neurocognitive questionnaire. Relative risks (RRs) and 95% CIs were used to estimate associations of neurocognitive impairment with treatment and health behaviors and conditions using generalized linear models. Results The cohort comprised 2375 survivors (mean [SD] age at evaluation, 31.8 [7.5] years; 1298 women [54.6%]) of childhood cancer, including acute lymphoblastic leukemia (ALL; 1316 participants), central nervous system (CNS) tumors (488 participants), and Hodgkin lymphoma (HL; 571 participants). A total of 232 siblings (mean [SD] age at evaluation, 34.2 [8.4] years; 134 women [57.8%]) were included. Compared with siblings, a higher ... |
| Document Type: |
article in journal/newspaper |
| Language: |
English |
| DOI: |
10.1001/jamanetworkopen.2023.16077 |
| Availability: |
https://doi.org/10.1001/jamanetworkopen.2023.16077; https://jamanetwork.com/journals/jamanetworkopen/articlepdf/2805444/phillips_2023_oi_230487_1684514524.04251.pdf |
| Accession Number: |
edsbas.B4EFB7AD |
| Database: |
BASE |