Exercise Habits Influence Mortality in Adult Survivors of Childhood Cancer

As they survive into and through adulthood, people who have had childhood cancer are at greater risk of dying from all causes than the general population, partially because early cancer treatment can cause lethal late effects. However, there are some proactive lifestyle modifications that can be beneficial.

Exercise is one example. Survivors of childhood cancer are no different from the general public with regard to exercise: they need it and it helps. A newly published study has found that there are clear benefits for young adult survivors of childhood cancer who exercise vigorously and continuously for a period of years. The main payoff is a longer life.

Method and End Points

For this multinational retrospective study, researchers in the United States, Canada, and Norway identified patients who had received a diagnosis of cancer before age 21 year. Inclusion criteria included diagnosis and primary treatment occurred at one of 27 medical centers in the United States and Canada between 1970 and 1999. Participants had to be at least 18 years old at the time of enrollment and had to have survived at least 5 years past the initial diagnosis. The researchers used follow-up questionnaires to determine new onset events, the most recent occurred between 2007 and 2009.

The primary end point of the study was all-cause mortality; secondary end points were cause-specific mortality. This was defined as recurrence or progression of the primary malignant neoplasm and mortality from other health-related causes such as subsequent malignant neoplasms (SMNs), or pulmonary or cardiovascular disease.

The investigators followed 15,450 adult survivors of childhood cancer for a mean of 10 years. The researchers considered variables such as gender; race; age at diagnosis; whether the participant smoked; level of education; and a cardiovascular disease risk profile that included obesity, dyslipidemia, diabetes, hypertension, and other symptoms of metabolic syndrome. The team also evaluated the survivors for chest radiation exposure, a number of chronic health conditions, cyclophosphamide and equivalent dose, and anthracycline and equivalent dose. Participants in this study were likely to be women, older in age, and have high body mass index (BMI). In addition, they were cigarette smokers and had other cardiovascular disease risk factors.