Key result
Asian survivors of childhood cancer experience a high prevalence of chronic treatment-related complications, with potential differences in the prevalence of certain late effects like secondary malignancy and obesity compared to non-Asian populations.
Why the study?
Chronic treatment-related complications in childhood cancer survivors remain an under-researched area in Asia despite the region bearing the largest share of the global childhood cancer burden.
What are the clinically ascertained health outcomes and late effects in Asian survivors of childhood cancer?
Systematic Review (n=13,442)
What are the clinically ascertained health outcomes and late effects in Asian survivors of childhood cancer?
This systematic review highlights the need for active screening and better access to survivorship care for Asian childhood cancer survivors due to prevalent chronic health problems and potential regional differences in late effects.
Supports targeted screening and survivorship care for Asian childhood cancer survivors; extends evidence on ethnic differences in late effects.
PURPOSE: Survivorship in children with cancer comes at a cost of developing chronic treatment-related complications. Yet, it is still an under-researched area in Asia, which shares the largest proportion of the global childhood cancer burden given its vast population. This systematic review summarizes existing literature on clinically ascertained health outcomes in Asian survivors of childhood cancer. METHODS: A search was conducted on Ovid Medline and EMBASE for studies that focused on survivors of childhood cancer from countries in East and Southeast Asia; adopted post-treatment clinical ascertainment of organ-specific toxicities or/and secondary malignancy. Studies were excluded if health outcomes were assessed during the acute treatment. RESULTS: Fifty-nine studies, enrolling a total of 13,442 subjects, were conducted on survivors of leukemia (34%), CNS tumor (14%), and cohorts of survivors with heterogeneous cancer diagnoses (52%). The studies used different medical evaluation methods to assess cardiovascular (15%), metabolic and infertility (32%), and neurological/neurocognitive (20%) outcomes in survivors. The collective findings suggest potential differences in the prevalence of certain late effects (e.g., secondary malignancy and obesity) among Asian and non-Asian populations, which may reflect differences in treatment regimens, practice, genetic variations, or/and socioeconomic disparity. CONCLUSIONS: We recommend developing collaborative initiatives to build a regional repository of systematically assessed health outcomes and biospecimens to investigate treatment, social-environmental and genetic predictors, and interventions for late effects in this population. IMPLICATIONS FOR CANCER SURVIVORS: The existing types of chronic health problems identified in this review suggest the need for active screening, better access to survivorship care, and promotion of protective health behavior in Asia.
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Poon et al. (2019) conducted a systematic review in Childhood cancer survivors (n=13,442). Childhood cancer treatments (chemotherapy, radiation, HSCT) was evaluated on Prevalence of clinically ascertained health outcomes (organ-specific toxicities and secondary malignancies). Asian survivors of childhood cancer experience a high prevalence of chronic treatment-related complications, with potential differences in the prevalence of certain late effects like secondary malignancy and obesity compared to non-Asian populations.
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