Validation of questionnaire-reported chest wall abnormalities with a telephone interview in Swiss childhood cancer survivors

M Ansari,Claudia E Kuehni,Marc Ansari,C Kuehni,For The Swiss Pediatric Oncology Group (Spog) Scientific Committee ,Rahel Kasteler,F Niggli,P Brazzola,F Schilling,N Von Der Weid,Christa Lichtensteiger,J Rössler,J Greiner,N Gerber,M Beck Popovic,Christina Schindera,H Hengartner,K Scheinemann

doi:10.1186/s12885-021-08425-z

Abstract

BackgroundChest wall abnormalities are a poorly studied complication after treatment for childhood cancer. Chest wall abnormalities are not well-described in the literature, and little is known on the impact on daily life of survivors.MethodsWe investigated prevalence and risk factors of chest wall abnormalities in childhood cancer survivors in a nationwide, population-based cohort study (Swiss Childhood Cancer Survivor Study) with a questionnaire survey. We then interviewed a nested sample of survivors to validate types of chest wall abnormalities and understand their impact on the daily life of survivors.ResultsForty-eight of 2382 (95%CI 2–3%) survivors reported a chest wall abnormality. Risk factors were older age at cancer diagnosis (16–20 years; OR 2.5, 95%CI 1.0–6.1), lymphoma (OR 3.8, 95%CI 1.2–11.4), and central nervous system tumors (OR 9.5, 95%CI 3.0–30.1) as underlying disease, and treatment with thoracic radiotherapy (OR 2.0, 95%CI 1.0–4.2), surgery to the chest (OR 4.5, 95%CI 1.8–11.5), or chemotherapy (OR 2.9, 95%CI 1.0–8.1). The nature of the chest wall abnormalities varied and included thoracic wall deformities (30%), deformations of the spine (5%) or both (55%), and scars (10%). Chest wall abnormalities affected daily life in two thirds (13/20) of those who reported these problems and necessitated medical attention for 15 (75%) survivors.ConclusionIt is important that, during follow-up care, physicians pay attention to chest wall abnormalities, which are rare late effects of cancer treatment, but can considerably affect the well-being of cancer survivors.

Highlights

Chest wall abnormalities are a poorly studied complication after treatment for childhood cancer
Some studies reported on specific cancer treatments such as thoracic radiotherapy, radiotherapy to the spine [6], abdominal radiotherapy [7, 8], or surgical interventions for solid tumours [5]
Swiss childhood Cancer survivor study The Swiss Childhood Cancer Survivor Study (SCCSS) is a population-based, long-term follow-up study of patients registered in the Swiss Childhood Cancer Registry (SCCR, www.childhoodcancerregistry.ch)

Summary

Introduction

Chest wall abnormalities are a poorly studied complication after treatment for childhood cancer. Some studies reported on specific cancer treatments such as thoracic radiotherapy, radiotherapy to the spine [6], abdominal radiotherapy [7, 8], or surgical interventions for solid tumours [5] Such studies are not representative of the entire population of childhood cancer survivors. Cross-sectional studies, 1.4% [11] (North America, multicenter study) to 2.0% [12] (Switzerland, population-based study) of survivors reported chest wall abnormalities in questionnaire surveys [10,11,12]. Survivors might not understand the term “chest wall abnormalities” in the way researchers intend They might choose to report different health issues as chest wall abnormalities, including thoracic wall deformities, spinal deformities, breast asymmetries, or scars. No study investigated whether and how chest wall abnormalities affect the daily life of survivors and if medical care is needed

Methods

Results

Discussion

Conclusion