Young Cancer Survivors at Higher Risk for Endocrine Disorders

July 30, 2018

According to a new study, young cancer survivors are at a 73% higher risk for endocrine disease.

Reference: Jensen MV, Rugbjerg K, de Fine Licht S, et al. Endocrine late effects in survivors of cancer in adolescence and young adulthood: A danish population-based cohort study. JAMA Network Open. 2018;1:e180349

Mette Jensen, MD, and colleagues in Denmark found that young cancer survivors are at nearly three-fourths higher risk for endocrine disease vs matched cancer-free young people. Click through the slides above for details on the study and take home messages for physicians.

Adolescent Cancer and Outcomes. Authors of the study sought to determine endocrine related late effects in adolescent/young adult cancer survivors vs the general population.

The Study. Authors conducted a large population-based cohort looking at adolescent and young adult cancer survivors in Denmark. The primary outcome was new diagnosis of endocrine disease starting 1 year after cancer diagnosis.

Results. The risk for any endocrine disease vs risk in the background population was higher in male survivors (RR, 2.41; 95% CI, 2.23-2.61) vs female survivors (RR, 1.46; 95% CI, 1.38-1.55), reflecting lower background rates of endocrine diseases in males.

Results (continued). The highest RRs for any endocrine disease were for leukemia, Hodgkin lymphoma, and brain cancer survivors:

Leukemia (RR, 3.97; 95% CI, 3.10-5.09)
Hodgkin lymphoma (RR, 3.06; 95% CI, 2.62-3.57)
Brain cancer (RR, 3.03; 95% CI, 2.53-3.64)

Take Home Points:

Adolescent and young adult cancer survivors are at 73% higher risk for endocrine disease vs similar cancer-free young people.
Be vigilant after cancer treatment in young people for signs and symptoms of endocrine dysfunction.
Screen patients treated with alkylating chemotherapy and irradiation for testicular dysfunction.
Testicular and breast cancer survivors are at significantly increased risk for hospital admission for endocrine disease.