Christen Salome, Roser Katharina, Mader Luzius, Otth Maria, Scheinemann Katrin, Sommer Grit, Kuehni Claudia, Michel Gisela
Faculty of Health Sciences and Medicine, University of Lucerne, Lucerne, Switzerland.
Cancer Registry Bern Solothurn, University of Bern, Bern, Switzerland.
Cancer Med. 2024 Apr;13(8):e7204. doi: 10.1002/cam4.7204.
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.
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.
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).
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.
儿童癌症及其治疗可对肌肉骨骼系统造成损害。我们旨在确定幸存者中肌肉骨骼健康状况（MSHC）的发病率和患病率，并调查与癌症相关特征的差异。
我们使用了儿童癌症登记处和瑞士儿童癌症幸存者研究的数据，包括研究时年龄≥15岁的幸存者（自诊断起≥5年；1976 - 2015年诊断时年龄<20岁）。MSHCs（骨质疏松症、肢体长度差异、关节活动受限、骨/关节疼痛、脊柱侧弯、胸部/肋骨变化和截肢）的累积发病率和患病率通过自我报告数据计算得出。
我们纳入了2645名幸存者（53%为男性；中位年龄24岁，范围15 - 59岁）。任何MSHC的患病率和累积发病率分别为21%和26%。任何MSHC的发病率为15.6/1000人年。脊柱侧弯（8%）、骨/关节疼痛（7%）和关节活动受限（7%）是最常见的MSHC。87%的幸存者中MSHC与其他健康状况同时存在。我们发现女性（RR = 1.
