NEW YORK (Reuters Health) - Long-term survivors of childhood malignancies are at increased risk for limitations in physical performance and are likely to have difficulty with certain activities of daily living (ADL), new research suggests.

While treatment for childhood cancers is known to cause functional limitations and impair ADLs, the prevalence of these problems and their relationship to cancer type and treatment received was unclear, the report indicates.

To investigate, Dr. Kirsten K. Ness, from the University of Minnesota in Minneapolis, and colleagues analyzed data from 11,481 subjects who were diagnosed with a malignancy before 21 years of age and survived at least 5 years. The cancers included primary brain cancer, leukemia, Hodgkin's disease, non-Hodgkin's lymphoma, kidney tumor, neuroblastoma, soft-tissue sarcoma or malignant bone tumor.

Subject surveys or, in the case of respondents younger than 18 years, parental surveys were conducted to assess functional ability; 3839 unaffected siblings served as the control group.

The researchers' findings appear in the November 1st issue of the Annals of Internal Medicine.

Survivors were 80% more likely than their siblings to report performance limitations, the authors note. In addition, survivors were at least four times more likely to describe restricted participation in personal care skills, routine activities, and the ability to attend school or work.

The survivors most likely to report performance limitations, restrictions in routine activities, and difficulty in attending school or work were those with brain and bone cancers. Moreover, brain cancer survivors were more likely than other survivors to report impairments in performing personal care.

The results indicate that "adult survivors of childhood cancer are at risk for performance limitations and participation restrictions many years after treatment," the researchers state. "Although not all late effects can be avoided or eliminated, their impact on physical performance and participation in routine activities can be influenced by rehabilitation measures designed to restore function or remediate loss in physical performance that may lead to participation restrictions."

Ann Intern Med 2005;143:639-647

Copyright © 2005 Reuters Limited. All rights reserved. Republication or redistribution of Reuters Limited content, including by framing or similar means, is expressly prohibited without the prior written consent of Reuters Limited. Reuters Limited shall not be liable for any errors or delays in the content, or for any actions taken in reliance thereon.