Somatische Langzeit- und Spätfolgen nach Krebs – Ergebnisse aus der epidemiologischen Literatur

Background: Advances in cancer diagnostics and treatment have led to a substantial increase in the number of long-term cancer survivors. In addition to recurrence and second primary malignancies, psychological and functional sequelae as well as (treatment-related) somatic long-term and late effects are becoming increasingly relevant for oncological follow-up care. Objective: The aim of this review is to summarize the quantitative evidence on somatic long-term and late effects among cancer survivors and to contextualize these findings with regard to risk-adapted follow-up care. Materials and methods: A narrative review of international epidemiological cohort and registry studies was conducted. Results: Epidemiological studies consistently demonstrate increased risks of cardiovascular, neurological, endocrine, metabolic, and pulmonary diseases as well as of secondary primaries among long-term survivors. Depending on the organ system involved, treatment exposure, and duration of follow-up, the relative risks generally range between 1.2 and 2.5. These late effects are characterized by long latency periods and the cooccurrence of multiple conditions, reflecting multimorbidity. Conclusion: Somatic long-term and late effects represent a substantial disease burden that is still insufficiently addressed in oncological follow-up care. The development of risk-adapted follow-up strategies requires a stronger focus on the integration of quantitative risk profiles.