UNDERWRITING ADULT SURVIVORS OF CHILDHOOD CANCERS
John R. Iacovino, MD Sr. Medical Director Fasano Associates, Longevity Holdings Wallace, NC Iacovinoconsult@aol.com
The overall survival of childhood cancer has dra- matically improved over the past decades (Figure 1). However, various types of cancer have very different 5-year survival rates (Figure 2, next page). Referring to Figure 2, it is important to note a 5-year survival is only being alive at 5 years. These individuals may still have active disease, be in remission or potentially cured. Those surviving beyond the 5-year or greater observation periods, even those with no evident dis- ease, have the potential for excess mortality in the future 1,2 (Figure 3, next page). The average survival of a person who had childhood cancer is 30% less than the general population. 3 They have a sixfold greater likelihood of developing a second cancer than the general population. 3
Executive Summary As the survival of childhood cancer dramatically improves, we are under- writing more adults with the potential and/or with current significant mortality complications resulting from their previous chemotherapy and radiation treatments. The overall 5-year survival of all childhood cancers is about 85%. However, more than 95% of people who survive their childhood cancer will incur a significant or severe health problem by age 45. Approximately one third will develop a severe or life-threatening complication causing premature death. The aver- age life expectancy of a 5-year survivor is about 60 years. The underwriter must be familiar with the types of treatment with their potential for future, not yet clinically evident, mortality impli- cations, and the prognosis of those with current active complications.
Figure 1. Survival Rate of Children and Adolescents (0-19 Years of Age) With Cancer in the US Over Time.
ON THE RISK vol.40 n.3 (2024)
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