Hospitalization rates among survivors of childhood cancer in the childhood cancer survivor study cohort

Abstract

Background Chronic health conditions are common among long‐term childhood cancer survivors, but hospitalization rates have not been reported. The objective of this study was to determine overall and cause‐specific hospitalization rates among survivors of childhood cancer and compare rates to the U.S. population. Procedure The Childhood Cancer Survivor Study (CCSS) is a retrospective cohort of 5+ year survivors of childhood malignancies treated at 26 participating centers. Self‐reported hospitalizations from 10,366 survivors (diagnosed 1970–1986) were compared to U.S. population rates using age‐ and sex‐stratified standardized incidence ratios (SIRs). Reasons for hospitalization were evaluated and associations between demographic, cancer and treatment‐related risk factors with hospitalization were investigated. Results Survivors were, on average, 20.9 years from cancer diagnosis (SD: 4.6, range: 13–32) and 28.6 years of age (SD: 7.7, range: 13–51). Survivor hospitalization rates were 1.6 times the U.S. population (95% CI: 1.6; 1.7). Increased hospitalization rates were noted irrespective of gender, age at follow‐up and cancer diagnosis, with highest SIRs noted among male (SIR = 2.6, 95% CI: 2.2; 3.0) and female (SIR = 2.7, 95% CI: 2.4; 3.1) survivors aged 45–54. Female gender, an existing chronic health condition and/or a second neoplasm, and prior treatment with radiation were associated with an increased risk of non‐obstetrical hospitalization. Conclusions Survivors of childhood cancer demonstrate substantially higher hospitalization rates. Additional research is needed to further quantify the healthcare utilization and economic impact of treatment‐related complications as this population ages. Pediatr Blood Cancer 2012; 59: 126–132. © 2011 Wiley Periodicals, Inc.