Clinical Edge

Summaries of Must-Read Clinical Literature, Guidelines, and FDA Actions

Predicting CV Risk in Childhood Cancer Survivors

J Clin Oncol; ePub 2017 Nov 2; Chow, Chen, et al

Clinicians can predict a childhood cancer survivor’s risk for subsequent ischemic heart disease and stroke when they are provided with certain information, according to a study involving >20,000 individuals. Investigators looked for the development of ischemic heart disease and stroke through age 50 in participants from the Childhood Cancer Survivor Study (n=13,060). Siblings (n=4,023) provided the baseline population risk, and findings were validated in 2 other cohorts (n=3,204). Among the results:

  • In the study cohort, ischemic heart disease occurred in 265 patients; 295 experienced a stroke.
  • Risk scores achieved both area under the curve and concordance statistics of 0.70 for ischemic heart disease.
  • For stroke, these statistics were 0.63 and 0.66, respectively.
  • Validation cohort statistics for ischemic heart disease were 0.66 to 0.67, respectively.
  • For stroke they were 0.68 to 0.72, respectively.
  • Cumulative incidence at age 50 in low-risk groups was <5%.
  • It was 20% in high-risk groups.


Chow E, Chen Y, Hudson M, et al. Prediction of ischemic heart disease and stroke in survivors of childhood cancer. [Published online ahead of print November 2, 2017]. J Clin Oncol. doi:10.1200/JCO.2017.74.8673.

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