Childhood cancer survivors lag in mammogram screenings: study

Women who were treated with chest radiation for a childhood cancer may not get breast cancer screenings recommended for them as adults even though they are at high risk for the disease, a new study suggests.

The researchers looked at 551 women in Canada and the U.S., age 25 through 50, who had survived pediatric cancer such as Hodgkin's disease and had been treated with moderate to high doses of chest radiation.

The pediatric survivors were diagnosed from 1970 to 1986.

Since the radiation can increase the risk of breast cancer, experts recommend that women have an annual mammogram starting at age 25, or eight years after radiation treatment, whichever is later.

The screenings are recommended to spot breast cancer at an early stage, when it tends to be the most treatable.

But in Wednesday's issue of JAMA, the Journal of the American Medical Association, Dr. Kevin Oeffinger of Memorial Sloan-Kettering Cancer Center in New York and his colleagues said they found among women ages 25 to 39 in the study, 47 per cent had never had a mammogram, and only 23 per cent had the screening in the past year.

"We anticipated that because many of these women are unaware of the risks and their physicians might not be aware of the risks that the breast cancer screening rates would be low, but they were much lower than we even expected," Oeffinger said.

More awareness needed

Among female cancer survivors who received chest radiation before age 21 and were aged 40 to 50 when the analysis was done, 52 per cent had regularly scheduled mammograms.

Raising awareness of the guidelines could make a difference, the researchers said.

If a doctor recommended screening for those at high risk, especially for those aged 25 to 39, they were three times more likely to have a mammogram than women whose doctors didn't suggest it, Oeffinger said.

"For me, knowledge is power," said Meg Owen, who survived Hodgkin's lymphoma in her early 20s. "Knowing that I am at higher risk, the screening actually gives me peace of mind."

As a comparison, the researchers also looked at 639 pediatric cancer survivors of the same ages who were not treated with chest radiation and 712 siblings of the survivors who did receive chest radiation.

The childhood cancer survivors had leukemia, brain tumours, Hodgkin lymphoma, non-Hodgkin lymphoma, renal tumours, neuroblastoma, soft tissue sarcomas, or bone tumours.

The researchers estimated that in the United States, there are approximately 20,000 to 25 000 women who are 25 years or older and were treated for a pediatric malignancy with moderate- to high-dose chest radiation. Worldwide, about 18 per cent to 20 per cent of female adult survivors of childhood cancer have been exposed to chest radiation.