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Falling risk of heart disease among survivors of childhood cancer

BMJ 2020; 368 doi: (Published 15 January 2020) Cite this as: BMJ 2020;368:m58

Linked Research

Major cardiac events for adult survivors of childhood cancer diagnosed between 1970 and 1999

  1. Mike Hawkins, chair in epidemiology1,
  2. Alex Brownsdon, clinical nurse specialist2,
  3. Raoul Reulen, senior lecturer1
  1. 1Centre for Childhood Cancer Survivor Studies, Institute of Applied Health Research, University of Birmingham, Birmingham B15 2TY, UK
  2. 2University College London Hospitals NHS Foundation Trust, London, UK
  1. Correspondence to M Hawkins m.m.hawkins{at}

Efforts to reduce the cardiotoxicity of treatments seem to be working

Large scale investigations have indicated substantial premature mortality among adult survivors of childhood cancer. In one cohort from Britain, 30% of participants who had survived childhood cancer for at least five years died by 45 years of diagnosis; just 6% were expected to have died.1 Beyond 45 years, most excess deaths in this cohort were caused by new primary cancers (51%) and cardiovascular disease (26%).1 Consequently, efforts to reduce long term mortality have focused on reducing exposure to the most toxic aspects of anticancer treatment, including radiotherapy. Several studies have evaluated the success of these efforts, considering specific causes of death,2 subsequent primary cancers,3 and chronic health conditions.4 A linked study by Mulrooney and colleagues (doi:10.1136/bmj.l6794) adds to this evidence base.

Using data from the Childhood Cancer Survivor Study (CCSS), based in the United States and Canada, the authors explored whether changes in anticancer treatment …

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