title: Is postal follow-up of childhood cancer survivors worthwhile?
abstract: BACKGROUND
  Childhood cancer survival has increased over the last 30 years, but long-term effects necessitate continued monitoring of survivors. Since not all of them attend follow-up clinics, this study assesses the efficacy of obtaining information from general practitioners (GPs) through a 5-year rolling postal program.
  
  
  METHODS
  Survivors were included who had been diagnosed with a malignancy in the West Midlands since 1957 and were not attending central long-term follow-up clinics.
  
  
  RESULTS
  One thousand twenty-seven patients were followed up between 1993 and 2004. Replies were received on 903 (88% response). There were 44 subsequent malignancies and 42 deaths. No medical problems were reported in 341/935 patients (36.5%); in the other 594 endocrine effects were the most common, with visual effects the biggest single problem. Brain tumor survivors had the largest proportion of problems.
  
  
  CONCLUSIONS
  The response rate and information quality achieved show that this method of follow-up is feasible, in cases of discharged or defaulting patients. These data will complement those derived from hospital-based follow-up studies, to give a broader understanding of the spectrum of late effects experienced by survivors and may inform the development of specific long-term follow-up protocols.
authors.affiliation: Oncology Department, Birmingham Children's Hospital, Steelhouse Lane, Birmingham, United Kingdom. sheila.parkes@bch.nhs.uk
authors.forename: Sheila E
authors.initials: SE
authors.lastname: Parkes
authors.forename: H C
authors.initials: HC
authors.lastname: Jenkinson
authors.forename: A
authors.initials: A
authors.lastname: Griffiths
authors.forename: D
authors.initials: D
authors.lastname: Kinch
authors.forename: J R
authors.initials: JR
authors.lastname: Mann
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000150:complications* / Q000401:mortality; D015996:Survival Rate; D017741:Survivors / Q000706:statistics & numerical data*; D006113:United Kingdom / Q000453:epidemiology