Phillips Siobhan M, Padgett Lynne S, Leisenring Wendy M, Stratton Kayla K, Bishop Ken, Krull Kevin R, Alfano Catherine M, Gibson Todd M, de Moor Janet S, Hartigan Danielle Blanch, Armstrong Gregory T, Robison Leslie L, Rowland Julia H, Oeffinger Kevin C, Mariotto Angela B
Department of Preventive Medicine, Northwestern University, Chicago, Illinois.
Division of Cancer Control and Population Sciences, National Cancer Institute, Bethesda, Maryland.
Cancer Epidemiol Biomarkers Prev. 2015 Apr;24(4):653-63. doi: 10.1158/1055-9965.EPI-14-1418.
No studies have estimated the population-level burden of morbidity in individuals diagnosed with cancer as children (ages 0-19 years). We updated prevalence estimates of childhood cancer survivors as of 2011 and burden of morbidity in this population reflected by chronic conditions, neurocognitive dysfunction, compromised health-related quality of life, and health status (general health, mental health, functional impairment, functional limitations, pain, and fear/anxiety).
Surveillance, Epidemiology, and End Results (SEER) Program data from 1975 to 2011 were used to update the prevalence of survivors of childhood cancers in the United States. Childhood Cancer Survivor Study data were used to obtain estimates of morbidity burden indicators, which were then extrapolated to SEER data to obtain population-level estimates.
There were an estimated 388,501 survivors of childhood cancer in the United States as of January 1, 2011, of whom 83.5% are ≥5 years after diagnosis. The prevalence of any chronic condition among ≥5-year survivors ranged from 66% (ages 5-19) to 88% (ages 40-49). Estimates for specific morbidities ranged from 12% (pain) to 35% (neurocognitive dysfunction). Generally, morbidities increased by age. However, mental health and anxiety remained fairly stable, and neurocognitive dysfunction exhibited initial decline and then remained stable by time since diagnosis.
The estimated prevalence of survivors of childhood cancer is increasing, as is the estimated prevalence of morbidity in those ≥5 years after diagnosis.
Efforts to understand how to effectively decrease morbidity burden and incorporate effective care coordination and rehabilitation models to optimize longevity and well-being in this population should be a priority.
尚无研究评估过儿童期（0 - 19岁）确诊癌症个体的人群层面发病负担。我们更新了截至2011年儿童癌症幸存者的患病率估计值，以及该人群中慢性病、神经认知功能障碍、健康相关生活质量受损和健康状况（总体健康、心理健康、功能损害、功能受限、疼痛和恐惧/焦虑）所反映的发病负担。
利用1975年至2011年监测、流行病学和最终结果（SEER）项目的数据更新美国儿童癌症幸存者的患病率。儿童癌症幸存者研究数据用于获取发病负担指标的估计值，然后将其外推至SEER数据以获得人群层面的估计值。
截至2011年1月1日，美国估计有388,501名儿童癌症幸存者，其中83.5%在诊断后≥5年。≥5岁幸存者中任何慢性病的患病率在66%（5 - 19岁）至88%（40 - 49岁）之间。特定疾病的估计患病率在12%（疼痛）至35%（神经认知功能障碍）之间。一般来说，发病率随年龄增长而增加。然而，心理健康和焦虑保持相对稳定，神经认知功能障碍在诊断后的最初阶段有所下降，之后保持稳定。
儿童癌症幸存者的估计患病率在上升，诊断后≥5年者的估计发病患病率也在上升。
了解如何有效降低发病负担并纳入有效的护理协调和康复模式以优化该人群的寿命和福祉的努力应成为优先事项。
