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Study Reveals Elevated Risk of Late-Onset Memory Impairment in Adult Childhood Cancer Survivors

Long-Term Impact of Cancer Treatment and Modifiable Health Behaviors Identified

A recent cohort study involving 2375 adult survivors of childhood cancer has shed light on their heightened susceptibility to late-onset neurocognitive impairments, particularly memory impairment. The study, conducted by the Childhood Cancer Survivor Study, compared these survivors to a control group of their siblings. The results indicated that the risk of new-onset memory impairment increased over the decades after the cancer diagnosis, with potential implications for future neurocognitive decline and dementia.

Key Findings:

  1. Increased Risk Over Time: The study revealed that survivors who initially showed no impairment in memory experienced new-onset memory impairment at follow-up, with rates significantly higher than their siblings.
  2. Association with Cancer Treatment: The risk of late-onset memory impairment was linked to specific cancer treatments, including chemotherapy and cranial radiation, suggesting a long-lasting impact of these interventions.
  3. Modifiable Risk Factors: Beyond treatment, modifiable health behaviors such as smoking, low educational attainment, and low physical activity were associated with an elevated risk of new-onset memory impairment.

Implications: The study’s findings suggest that adult survivors of childhood cancer face a sustained risk of cognitive decline, even if they did not exhibit neurocognitive impairments shortly after therapy. The identified risk factors, both related to treatment and lifestyle, highlight the importance of ongoing neurocognitive surveillance for this population.

Recommendations:

  1. Neurocognitive Surveillance: The study emphasizes the need for regular neurocognitive assessments in all childhood cancer survivors, irrespective of their initial cognitive status after completing therapy.
  2. Early Intervention for Modifiable Risk Factors: Health care practitioners are encouraged to target modifiable risk factors, such as obesity, smoking, and low physical activity, in childhood to reduce the risk of chronic health morbidities and potentially mitigate the risk of accelerated neurocognitive decline.
  3. Adherence to Survivorship Screening Recommendations: Serial evaluations of neurocognitive function and adherence to survivorship late-effects screening recommendations are crucial for maintaining cognitive function in aging cancer survivors.

Conclusion: The study’s comprehensive analysis provides valuable insights into the long-term cognitive risks faced by adult survivors of childhood cancer. The identified risk factors underscore the importance of holistic care strategies that address both treatment-related and modifiable health factors to enhance the quality of life for this growing population of survivors.

Credit: JAMA Network Open