There has been a decline in cardiac disease among survivors of childhood cancer since the 1970s, finds a study in the BMJ.
The study collected data from 27 institutions for 23,462 five-year survivors of leukaemia, brain cancer, Hodgkin and non-Hodgkin lymphoma, renal tumours, neuroblastoma, soft tissue sarcomas, and bone sarcomas diagnosed before age 21 years. Of these, 26.4 per cent were treated in the 1970s, 39.9 per cent in the 1980s and 33.6 per cent in the 1990s.
It found a decrease in the 20-year cumulative incidence of heart failure (0.69% for 1970s, 0.74% for 1980s, 0.54% for 1990s) and coronary artery disease (0.38%, 0.24%, 0.19%, respectively). However, this was not true of valvular disease, pericardial disease or arrhythmias.
Compared to those diagnosed in the 1970s, the risk of heart failure, coronary artery disease, and valvular heart disease decreased in the 1980s and 1990s but was only significant for coronary artery disease.
The overall risk of coronary artery disease was attenuated by adjustment for cardiac radiation, particularly among Hodgkin lymphoma survivors.
The findings suggest efforts to modify cancer therapies in children and promote health surveillance are beginning to show benefits for survivors of childhood cancer.