Description

The majority of children diagnosed with cancer will reach adulthood. Childhood cancer survivors require unique medical follow-up. Risks of late effects depend on the treatments received as well as the type and site of cancer. The Children’s Oncology Group’s long-term follow-up guidelines serve as the basis for many of the recommendations in this chapter.

Epidemiology

• Long-term survival into adulthood for a child diagnosed with cancer is nearly 80%.
• Among adults treated for childhood cancer:
  • Nearly 2/3 of survivors will develop one or more chronic health condition.
  • Nearly 1/3 of survivors will experience severe or life-threatening complications during adulthood.
• Approximately 450,000 childhood cancer survivors live in the United States.
• These numbers will continue to grow as new cancer therapies become available and more children survive.

Risk Factors

Late effects of cancer therapy are influenced by tumor-related, treatment-related and host factors.

Pathophysiology

Risk of organ dysfunction is related to primary cancer location and treatment used. See detailed systems-based evaluations in the following sections.