title: Transition of care for young adult survivors of childhood and adolescent cancer: rationale and approaches.
abstract: OBJECTIVE
  Young adult survivors of childhood and adolescent cancer are an ever-growing population of patients, many of whom remain at lifelong risk for potentially serious complications of their cancer therapy. Yet research shows that many of these older survivors have deficient health-related knowledge and are not engaging in recommended health promotion and screening practices that could improve their long-term outcomes. The purpose of this review is to address these disparities by discussing how formal transition of care from pediatric to adult-focused survivorship services may help meet the unique medical, developmental, and psychosocial challenges of these young adults.
  
  
  METHODS
  Literature review and discussion.
  
  
  RESULTS
  This article summarizes current research documenting the medical needs of young adult survivors, their suboptimal compliance with recommended follow-up, and the rationale, essential functions, current models, and innovative approaches for transition of follow-up care.
  
  
  CONCLUSIONS
  Systematic health care transition constitutes the standard of care for young adult survivors of childhood cancer. In developing a transitional care program, it is necessary to consider the scope of services to be provided, available resources, and other local exigencies that help determine the optimal model for use. Additional research is needed to improve health services delivery to this population. Effective advocacy is needed, particularly in the United States, to ensure the availability of uninterrupted health insurance coverage for survivorship services in young adulthood.
authors.affiliation: LIFE Survivorship and Transition Program, Childrens Center for Cancer and Blood Diseases, Childrens Hospital Los Angeles, and Department of Pediatrics, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA. dfreyer@chla.usc.edu
authors.forename: David R
authors.initials: DR
authors.lastname: Freyer
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D003266:Continuity of Patient Care; D003695:Delivery of Health Care; D006293:Health Promotion; D006801:Humans; D008134:Long-Term Care; D009369:Neoplasms / Q000628:therapy*; D010349:Patient Compliance; D010353:Patient Education as Topic; D059039:Standard of Care; D017741:Survivors; D016896:Treatment Outcome