Childhood Cancer Survivors Face Increased Long-Term Health Risks, Study Finds
A new study led by researchers at City of Hope has revealed that childhood cancer survivors experience a significantly elevated risk of developing secondary cancers and other health problems as they age, notably after reaching 50.This research, published in the Journal of Clinical Oncology, is the first comprehensive look at this growing population, as advancements in cancer treatment are leading to longer survival rates.
Currently, approximately 15,000 children and adolescents are diagnosed with cancer annually in the U.S., and the five-year survival rate has dramatically increased from 58% decades ago to 85% today. This positive trend necessitates a deeper understanding of the long-term consequences faced by these survivors.
The study, spearheaded by Dr. Rahul Bhandari, an oncologist at City of Hope and the study’s corresponding author, analyzed data from a national database encompassing nearly 40,000 individuals diagnosed with cancer before the age of 21. Researchers, including Dr. Saro Armenian, a pediatric hematologist-oncologist at City of Hope Children’s Cancer Center, focused on those still living at age 50, comparing their incidence of new cancers to the general population and assessing chronic health conditions in relation to their siblings.The findings indicate that childhood cancer survivors are five times more likely to die from cancer after age 50 compared to their peers. They also exhibit a heightened risk of heart disease, experiencing cardiac issues at age 55 comparable to those typically seen in 70-year-olds. Furthermore, survivors reported greater frailty, difficulty with physical activity, and overall poorer health.
Interestingly, the research pinpointed radiation therapy as the primary driver of these future health risks, outweighing the impact of chemotherapy. Dr. Armenian explained that radiation causes DNA damage at a cellular level, increasing the potential for mutations and the progress of new cancers.
While the study’s data reflects treatment protocols from the 1970s and 80s, a period before significant advancements in targeted therapies and immunotherapy, the researchers emphasize the need for continued vigilance. Modern cancer treatment has evolved, with a greater emphasis on minimizing or avoiding radiation in favor of more precise approaches.
“Some survivors should begin screening for cancers like breast or colon cancer earlier than the standard recommendations for the general public,” Dr. Armenian stated. “A collaborative approach is crucial to ensure survivors recieve the necessary preventative care and screenings for potential secondary cancers and other health concerns.”
Despite the increased physical health risks, the study offered a positive note regarding mental well-being.Cancer survivors were found to be no more likely to experience mental health issues than their siblings at age 50. Dr. Bhandari attributed this to the resilience and positive outlook often demonstrated by long-term survivors, highlighting their inspiring journeys.
Source: Bhandari,R.,et al. (2025) Health Outcomes Beyond Age 50 years in Survivors of Childhood Cancer: A Report From the Childhood Cancer Survivor Study. Journal of Clinical Oncology. doi.org/10.1200/JCO-25-00385.