Long-term follow-up of pediatric cancer survivors: education, surveillance, and screening.
Cancer and its treatment predispose childhood cancer survivors to chronic or late occurring health problems that may not become clinically significant until many years after therapy. Frequently, long-term survivors of childhood cancer report late cancer-related effects that diminish quality of life and increase the risk of early mortality. Risk-based health care that involves a personalized plan for surveillance, screening, and prevention is recommended to reduce cancer-related morbidity in childhood cancer survivors. To implement optimal risk-based care, the survivor and health care provider must have accurate information about cancer diagnosis, treatment modalities, and potential cancer-related health risks to guide screening and risk-reducing interventions. However, previous studies evaluating health knowledge of childhood cancer survivors demonstrate noteworthy deficits and misperceptions about their cancer diagnosis, treatment, and cancer-related health risks. In addition, because of the relative rarity of childhood cancer, many health care providers lack familiarity with cancer-related health risks and risk-reduction methods relevant for this population. To correct these deficits, the Scottish Intercollegiate Guidelines Network (SIGN) and the Children's Oncology Group (COG) developed clinical practice guidelines to foster appropriate risk-based survivor care. Herein, we discuss the development, benefits, and limitations of the SIGN and COG guidelines and the foundation they provide for standardizing long-term follow-up care of the ever-growing vulnerable population of childhood cancer survivors.
Landier
Wendy
W
City of Hope Comprehensive Cancer Center, Duarte, California, USA.
Wallace
W Hamish B
WH
Hudson
Melissa M
MM
D000293:Adolescent; D000359:Aftercare / Q000191:economics / Q000458:organization & administration / Q000639:trends; D002648:Child; D002675:Child, Preschool; D003695:Delivery of Health Care / Q000191:economics / Q000458:organization & administration / Q000639:trends; D018572:Disease-Free Survival; D005260:Female; D005500:Follow-Up Studies; D019983:Guideline Adherence / Q000191:economics / Q000592:standards / Q000639:trends; D006801:Humans; D007223:Infant; D008297:Male; D008403:Mass Screening / Q000191:economics / Q000458:organization & administration / Q000639:trends; D009369:Neoplasms / Q000191:economics / Q000401:mortality / Q000523:psychology / Q000628:therapy; D010353:Patient Education as Topic / Q000458:organization & administration / Q000592:standards; D017410:Practice Guidelines as Topic / Q000592:standards; D011785:Quality Assurance, Health Care / Q000191:economics / Q000458:organization & administration / Q000639:trends; D011788:Quality of Life; D012307:Risk Factors