Childhood cancer survivors at increased risk for GI complications

Health care providers should be aware that survivors of childhood cancer have an increased risk of developing gastrointestinal (GI) complications later in life and provide appropriate follow-up care, a study published in Gastroenterology indicates.

Using data from the Childhood Cancer Survivor Study, researchers from the University of California, San Francisco, and other institutions evaluated the frequency of self-reported GI complications in 14,358 childhood cancer survivors who were treated between 1970 and 1986 and survived at least 5 years after diagnosis. Data were compared with those from randomly selected siblings. Median age at cancer diagnosis was 6.8 years; median age at outcome assessment was 23.2 years for survivors and 26.6 years for siblings.

Overall, more than 40% of the survivors reported having some type of late GI complication by 20 years after cancer treatment. Compared with siblings, survivors were more likely to have late-onset upper GI complications (eg, ulcers, esophageal disease, and indigestion), lower GI complications (eg, intestinal polyps, chronic diarrhea, and colitis), and liver conditions (eg, cirrhosis, gallstones, and jaundice). Survivors also were more likely to require colostomy/ileostomy or liver biopsy. Older age at diagnosis and more intensive therapy, including chemotherapy, abdominal radiation, and abdominal surgery, increased the risk of certain GI complications.

Although cancer therapies are known to cause GI complications at the time of treatment, this study examined long-term GI complications in childhood cancer survivors. According to the investigators, these findings indicate that late GI complications in childhood cancer survivors are relatively common and can have a significant effect on their quality of life. Health care providers should be aware of these potential problems as they evaluate acute symptoms and plan follow-up care.

The researchers note, however, that as cancer therapies evolve, the risks of late GI complications may change, and studies of more recently treated patients will be needed.

Goldsby R, Chen Y, Raber S, et al. Survivors of childhood cancer have increased risk of gastrointestinal complications later in life. Gastroenterology. 2011;140(5):1464.e1-1471.e1.