Thank you to Schell and colleagues for your interest in our manuscript. We agree that there is a need for further research into the mechanisms of co-existence of cancer and comorbid diseases and the need for development and application of comorbidity assessment and management tools that are validated in the younger cohort. We wish to stress however that our study did not include patients younger than 50 years and thus we are not able to comment on the relationship of cancer and comorbid diseases in individuals younger than 50. Other large cohort studies have demonstrated higher prevalence of comorbidities of survivors of childhood cancer emphasizing the importance of this issue in all cancer survivors and underscoring the importance of research in this area [1]. It is unclear if the etiology and mechanisms for cancer and chronic disease development in paediatric/adolescent individuals with cancer is similar or different to those in middle age and older adults. Future research including preclinical and animal model research may shed a light into this intriguing area.
Reference
Oeffinger KC et al (2006) Chronic health conditions in adult survivors of childhood cancer. N Engl J Med 355(15):1572–1582
Author information
Authors and Affiliations
Contributions
All authors contributed to the conceptualization and writing.
Corresponding author
Ethics declarations
Consent to publish
All authors granted the consent to publish the manuscript.
Conflict of interest
Dr Koczwara was a supervisor of Ms Schell who is a medical student at the Flinders University. Dr Koczwara did not solicit Ms Schell’s letter nor contributed to it.
Additional information
Publisher's Note
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Rights and permissions
About this article
Cite this article
Koczwara, B., Deckx, L., Ullah, S. et al. Response to Schell and colleagues. Support Care Cancer 30, 1897 (2022). https://doi.org/10.1007/s00520-021-06765-x
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00520-021-06765-x