Survivors of childhood cancer have increased risk of gastrointestinal complications later in life.

Journal Article (Journal Article;Multicenter Study)

BACKGROUND & AIMS: Children who receive cancer therapy experience numerous acute gastrointestinal (GI) toxicities. However, the long-term GI consequences have not been extensively studied. We evaluated the incidence of long-term GI outcomes and identified treatment-related risk factors. METHODS: Upper GI, hepatic, and lower GI adverse outcomes were assessed in cases from participants in the Childhood Cancer Survivor Study, a study of 14,358 survivors of childhood cancer who were diagnosed between 1970 and 1986; data were compared with those from randomly selected siblings. The median age at cancer diagnosis was 6.8 years (range, 0-21.0 years), and the median age at outcome assessment was 23.2 years (5.6-48.9 years) for survivors and 26.6 years (1.8-56.2 years) for siblings. Rates of self-reported late GI complications (occurred 5 or more years after cancer diagnosis) were determined and associated with patient characteristics and cancer treatments, adjusting for age, sex, and race. RESULTS: Compared with siblings, survivors had increased risk of late-onset complications of the upper GI tract (rate ratio [RR], 1.8; 95% confidence interval [CI], 1.6-2.0), liver (RR, 2.1; 95% CI, 1.8-2.5), and lower GI tract (RR, 1.9; 95% CI, 1.7-2.2). The RRs for requiring colostomy/ileostomy, liver biopsy, or developing cirrhosis were 5.6 (95% CI, 2.4-13.1), 24.1 (95% CI, 7.5-77.8), and 8.9 (95% CI, 2.0-40.0), respectively. Older age at diagnosis, intensified therapy, abdominal radiation, and abdominal surgery increased the risk of certain GI complications. CONCLUSIONS: Individuals who received therapy for cancer during childhood have an increased risk of developing GI complications later in life.

Full Text

Duke Authors

Cited Authors

  • Goldsby, R; Chen, Y; Raber, S; Li, L; Diefenbach, K; Shnorhavorian, M; Kadan-Lottick, N; Kastrinos, F; Yasui, Y; Stovall, M; Oeffinger, K; Sklar, C; Armstrong, GT; Robison, LL; Diller, L

Published Date

  • May 2011

Published In

Volume / Issue

  • 140 / 5

Start / End Page

  • 1464 - 71.e1

PubMed ID

  • 21315721

Pubmed Central ID

  • PMC3081911

Electronic International Standard Serial Number (EISSN)

  • 1528-0012

Digital Object Identifier (DOI)

  • 10.1053/j.gastro.2011.01.049


  • eng

Conference Location

  • United States