title: Endocrine health problems detected in 519 patients evaluated in a pediatric cancer survivor program.
abstract: BACKGROUND
  Many pediatric cancer survivors have endocrine conditions. Surveillance for late effects is recommended by national guidelines. Endocrine surveillance is recommended after alkylating agents, steroids, methotrexate, and radiation.
  
  
  OBJECTIVE
  The objective of the study was to describe the endocrine outcomes in patients followed up in a program that uses national screening guidelines.
  
  
  METHODS
  The design of the study was a medical records review.
  
  
  METHODS
  The study was conducted in the Comprehensive Cancer Survivor Program, an academic pediatric oncology program.
  
  
  METHODS
  The study included 519 pediatric and young adult survivors of noncentral nervous system childhood malignancies between January 1, 2001, and December 15, 2005.
  
  
  METHODS
  Patients were evaluated with history, physical examinations, and evaluations recommended in the Children's Oncology Group's Long-Term Follow-Up Guidelines for Survivors of Childhood, Adolescent and Young Adult Cancers.
  
  
  METHODS
  The frequency and types of endocrine conditions were measured.
  
  
  RESULTS
  Four hundred eighty endocrine conditions were observed in 299 survivors (57.6% of survivors). The most common types of endocrine conditions were problems with weight and gonadal function. In a Cox regression model, stem cell transplant, radiation, and older age at cancer diagnosis were associated with higher hazard of an endocrine condition. Radiation, stem cell transplant, and sarcoma diagnosis were associated with growth problems.
  
  
  CONCLUSIONS
  Endocrine disorders were common after pediatric cancers. Endocrinologists should be aware of national guidelines, anticipate referral of pediatric cancer survivors, and participate in further research to optimize screening for and treatment of endocrine effects of cancer therapy.
authors.affiliation: Emory University School of Medicine, Department of Pediatrics, M.S., Emory Children's Center, 2015 Uppergate Drive, Suite 232 NE, Atlanta, Georgia 30322, USA. bcpatte@emory.edu
authors.forename: Briana C
authors.initials: BC
authors.lastname: Patterson
authors.forename: Karen
authors.initials: K
authors.lastname: Wasilewski-Masker
authors.forename: A Blythe
authors.initials: AB
authors.lastname: Ryerson
authors.forename: Ann
authors.initials: A
authors.lastname: Mertens
authors.forename: Lillian
authors.initials: L
authors.lastname: Meacham
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D004700:Endocrine System Diseases / Q000150:complications* / Q000175:diagnosis*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D009369:Neoplasms / Q000150:complications*; D010808:Physical Examination; D012189:Retrospective Studies; D017741:Survivors; D055815:Young Adult