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Compared to the general population, adult survivors of childhood cancer have a greater chance of developing cardiovascular disease, lung problems and second malignancies because the long-term effects of the original cancer and its treatment, as well as some genetic predispositions, leaves them vulnerable to multiple cancers. Smoking would be just added risk for this population.
The findings, published in the July 29 online issue of the Journal of the National Cancer Institute, are based on more than 10 000 surveys received back from adult survivors who were first diagnosed with cancer between 1940 and 1991.
Researchers learned those who had central nervous system cancers or heritable retinoblastoma were least likely to smoke, while survivors of Wilms' tumor, Hodgkin's lymphoma or soft tissue sarcomas were most likely to report being a regular current smoker. Those treated with radiation or chemotherapy were less likely to be smokers than individuals who had not received that type of therapy.
Smokers risk second malignancies
Respondents who did not have regular hospital follow-up appointments were more likely to smoke than those who did.
The higher rate of smoking among survivors of Wilms' tumor, Hodgkin's lymphoma, and soft tissue sarcomas is alarming as, based on past research, these individuals have a particularly high risk for second malignancies.
The researchers concluded that although the rate of smoking in adult survivors of childhood cancer is approximately half that of the general British population, reducing smoking prevalence in this group requires greater effort. In general, any program of clinical follow-up for survivors of childhood cancer should include advice on the health risks of smoking, the authors said.
In an accompanying editorial, Karen Emmons, of the Dana-Farber Cancer Institute and Harvard School of Public Health in Boston, noted that the new report had remarkably similar findings to a US Childhood Cancer Survivor Study.
In that research, 17 percent of adult US survivors reported being current smokers and 28 percent reported having been regular smokers at some time.
Emmons backed the British researchers' call to increase efforts to reduce the rate of smoking in adult cancer survivors, noting that fewer than half of the survivorship programs in the Unites States offer smoking cessation services. – (HealthDay News, August 2008)
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