Cancer Medicine (Apr 2024)

Incidence and prevalence of musculoskeletal health conditions in survivors of childhood and adolescent cancers: A report from the Swiss childhood cancer survivor study

  • Salome Christen,
  • Katharina Roser,
  • Luzius Mader,
  • Maria Otth,
  • Katrin Scheinemann,
  • Grit Sommer,
  • Claudia Kuehni,
  • Gisela Michel

DOI
https://doi.org/10.1002/cam4.7204
Journal volume & issue
Vol. 13, no. 8
pp. n/a – n/a

Abstract

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Abstract Purpose Childhood cancer and its treatment can cause damage to the musculoskeletal system. We aimed to determine the incidence and prevalence of musculoskeletal health conditions (MSHC) in survivors, and to investigate differences by cancer‐related characteristics. Methods We used data from the Childhood Cancer Registry and the Swiss Childhood Cancer Survivor Study, including survivors (≥5 years since diagnosis; diagnosed 1976–2015 at <20 years of age) aged ≥15 years at study. Cumulative incidence and prevalence of MSHCs (osteoporosis, limb length discrepancy, limited joint mobility, bone/joint pain, scoliosis, changes to chest/ribs and amputation) were calculated from self‐reported data. Results We included 2645 survivors (53% men; median age 24 years, range 15–59 years). Prevalence and cumulative incidence of any MSHC was 21% and 26%, respectively. Incidence rate for any MSHC was 15.6/1000 person‐years. Scoliosis (8%), bone/joint pain (7%) and limited joint mobility (7%) were the most prevalent MSHC. MSHC co‐occurred with other health conditions in 87% of survivors. We found increased rates of MSHC in women (RR = 1.4, 95%CI: 1.2–1.7), bone tumour survivors (RR = 6.0, 95%CI: 4.5–7.9), survivors older at diagnosis (11–15 years: RR = 1.8, 95%CI: 1.5–2.3), after a relapse (RR = 1.5, 95%CI: 1.3–1.9), treatment with surgery (RR = 1.2, 95%CI: 1.0–1.5), chemotherapy (RR = 1.4, 95%CI: 1.1–1.8) or stem cell transplantation (RR = 1.6, 95%CI: 1.0–2.5), and more recent year of diagnosis (2011–2015: RR = 4.3, 95%CI: 2.8–6.8). Conclusion MSHCs are prevalent in survivors, the risk is increasing in younger survivor cohorts, and MSHCs usually occur in multimorbid survivors. Strengthening of rehabilitation services and appropriate referrals are needed to mitigate the effects of the cancer and cancer treatment.

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