Document Detail

Fractures among long-term survivors of childhood cancer: a report from the Childhood Cancer Survivor Study.
MedLine Citation:
PMID:  22605509     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Although reductions in bone mineral density are well documented among children during treatment for cancer and among childhood cancer survivors, little is known about the long-term risk of fracture. The objective of this study was to ascertain the prevalence of and risk factors for fractures among individuals participating in the Childhood Cancer Survivor Study (CCSS).
METHODS: Analyses included 7414 ≥ 5-year survivors of childhood cancer diagnosed between 1970 and 1986 who completed the 2007 CCSS follow-up questionnaire and a comparison group of 2374 siblings. Generalized linear models stratified by sex were used to compare the prevalence of reported fractures between survivors and siblings.
RESULTS: The median ages at follow-up among survivors and siblings were 36.2 years (range, 21.2-58.8 years) and 38.1 years (range, 18.4-62.6 years), respectively, with a median 22.7 years of follow-up after cancer diagnosis for survivors. Approximately 35% of survivors and 39% of siblings reported ≥ 1 fracture during their lifetime. The prevalence of fractures was lower among survivors than among siblings, both in males (prevalence ratio, 0.87; 95% confidence interval, 0.81-0.94; P < .001) and females (prevalence ratio, 0.94; 95% confidence interval, 0.86-1.04; P = .22). In multivariable analyses, increasing age at follow-up, white race, methotrexate treatment, and balance difficulties were associated with increased prevalence of fractures among female survivors (P = .015). Among males, only smoking history and white race were associated with an increased prevalence of fracture (P < .001).
CONCLUSIONS: Findings from this study indicated that the prevalence of fractures among adult survivors did not increase compared with that of siblings. Additional studies of bone health among aging female cancer survivors may be warranted.
Carmen L Wilson; Kimberley Dilley; Kirsten K Ness; Wendy L Leisenring; Charles A Sklar; Sue C Kaste; Marilyn Stovall; Daniel M Green; Gregory T Armstrong; Leslie L Robison; Nina S Kadan-Lottick
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Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't     Date:  2012-05-17
Journal Detail:
Title:  Cancer     Volume:  118     ISSN:  1097-0142     ISO Abbreviation:  Cancer     Publication Date:  2012 Dec 
Date Detail:
Created Date:  2012-11-20     Completed Date:  2013-03-06     Revised Date:  2014-05-01    
Medline Journal Info:
Nlm Unique ID:  0374236     Medline TA:  Cancer     Country:  United States    
Other Details:
Languages:  eng     Pagination:  5920-8     Citation Subset:  AIM; IM    
Copyright Information:
Copyright © 2012 American Cancer Society.
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MeSH Terms
Age Factors
Bone Density
Child, Preschool
Fractures, Bone / complications*,  epidemiology*
Infant, Newborn
Middle Aged
Neoplasms / complications*
Grant Support
5P30CA021765-33/CA/NCI NIH HHS; P30 CA021765/CA/NCI NIH HHS; U24 CA055727/CA/NCI NIH HHS; U24CA055727/CA/NCI NIH HHS

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