Endocrine and metabolic late effects in childhood cancer survivors in Germany: the VersKiK study
Year: 2026
Type: article
Study design: Observational Study
Abstract: OBJECTIVE: Endocrine and metabolic diseases are known to be common late effects in childhood cancer survivors (CCS). We assessed the prevalence of these diseases in a large German CCS cohort, and a matched comparison population, using health claims data. DESIGN: The cohort study was based on record-linkage between the nationwide German Childhood Cancer Registry and claims data from 13 major German statutory health insurances. METHODS: The monitored insurance period covered the years 2017-2021. We assessed the frequencies of endocrine and metabolic diseases among 11 863 5-year CCS, diagnosed 1991-2021, with continuous insurance coverage and a matched comparison group of 35 589 insured persons without a history of childhood cancer. We present prevalence and Prevalence Ratios (PR) with corresponding 95% confidence intervals (95%CI). RESULTS: At least one endocrine or metabolic disease was recorded in 31.3% of survivors (n=3716) and in 16.4% of the comparison group (n=5819, PR=1.9; 95%CI: 1.8-2.0). The frequency of diseases was higher among females than among males in both groups. The PR was 2.4 (95%CI: 2.3-2.5) for males and 1.6 (95%CI: 1.5-1.7) for females. The frequency of at least one disease increased with increasing attained age. The disease with the highest frequency among CCS was hypothyroidism (15.85%), the highest PR was estimated for patients with primary thyroid cancer (43.5; 95%CI: 24.2-78.1). CONCLUSIONS: Our study highlights the increased vulnerability of CCS to endocrine and metabolic diseases compared to the general population and underscores the need for risk-adapted surveillance during the whole survivorship trajectory.
Authors: Pietro Trocchi, Enno Swart, Ekaterina Aleshchenko, Hiltrud Merzenich, Cecile Ronckers, Katja Baust, Gabriele Calaminus, Thorsten Langer, Peter Ihle, Jutta Küpper-Nybelen, Christian Lüpkes, Patrik Dröge, Thomas Ruhnke, Dirk Horenkamp-Sonntag, Ursula Marschall, Melanie Klein, Claudia Spix, Christian Apfelbacher, Judith Gebauer
Institutions: Otto-von-Guericke-Universität Magdeburg, Johannes Gutenberg University Mainz, University Medical Center of the Johannes Gutenberg University Mainz, German Cancer Research Center, University Hospital Bonn, University Hospital Schleswig-Holstein, University of Cologne, University Hospital Cologne, Oldenburger Institut für Informatik, Wissenschaftliches Institut der AOK, Techniker Krankenkasse (Germany), DAK-Gesundheit (Germany), University Hospital Leipzig, Leipzig University
Language: English
Field: Medicine
Domain: Health Sciences
Open Access status: hybrid
Estimated APC paid: $4,292
Funder: Gemeinsame Bundesausschuss
OpenAlex ID: W7124977606
