title: Caring for survivors of childhood cancers: the size of the problem.
abstract: Many survivors of childhood cancer have significant health problems due to their illness or treatment. This population-based study examines the number of long-term survivors, their disabilities and consequent long-term care needs. Survival rates for children diagnosed with cancer between 1960 and 1999 in the West Midlands, United Kingdom (UK), were used to estimate future long-term survivor numbers. Treatment and late effects data on a cohort of patients surviving for more than 5 years were used to consider continuing care needs. Between the 1960s and 1990s, 5-year survival increased from 23% to 70%. There were 98 5-year survivors in 1970, and numbers may exceed 2,100 by the end of 2005. Most (at least 61%) survivors in the West Midlands Region have one or more chronic medical problems and may require multidisciplinary care. We conclude that, in order to determine how to provide cost-effective care for this increasing population, protocol delivered management with audit is needed.
authors.affiliation: Department of Oncology, Birmingham Children's Hospital, Steelhouse Lane, Birmingham B4 6NH, UK.
authors.forename: H L
authors.initials: HL
authors.lastname: Curry
authors.forename: S E
authors.initials: SE
authors.lastname: Parkes
authors.forename: J E
authors.initials: JE
authors.lastname: Powell
authors.forename: J R
authors.initials: JR
authors.lastname: Mann
mesh_terms: D000293:Adolescent; D002648:Child; D002662:Child Health Services / Q000458:organization & administration*; D002675:Child, Preschool; D004739:England / Q000453:epidemiology; D005500:Follow-Up Studies; D006304:Health Status; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008134:Long-Term Care; D009369:Neoplasms / Q000401:mortality* / Q000628:therapy; D016019:Survival Analysis; D017741:Survivors / Q000706:statistics & numerical data*