title: Approaches to reduce the long-term burden of treatment-related complications in survivors of childhood cancer.
abstract: Advances in diagnostics, treatment strategies, and supportive care have contributed to a marked improvement in outcomes for children with cancer. This has resulted in a growing number of long-term childhood cancer survivors. Currently there are over 360,000 individuals who are survivors of childhood cancer in the United States. However, treatment for patients with childhood cancer with chemotherapy, radiation, and/or hematopoietic stem cell transplantation can result in health-related complications that may not become evident until years after completion of treatment. As a result, several initiatives have been established to help standardize the surveillance for treatment-related late effects in childhood cancer survivors. This review highlights emerging concepts related to commonly reported late effects, such as subsequent malignant neoplasms, cardiovascular disease, and endocrinopathies. It also discusses relevant population-based screening strategies to mitigate the long-term health-related burden in vulnerable populations of survivors.
authors.affiliation: From the Department of Population Sciences, City of Hope, Duarte, CA; Department of Pediatric Oncology, Emma Children's Hospital/Academic Medical Center, Amsterdam, Netherlands; Department of Pediatrics, Memorial Sloan Kettering Cancer Center, New York, NY.
authors.forename: Saro H
authors.initials: SH
authors.lastname: Armenian
authors.affiliation: From the Department of Population Sciences, City of Hope, Duarte, CA; Department of Pediatric Oncology, Emma Children's Hospital/Academic Medical Center, Amsterdam, Netherlands; Department of Pediatrics, Memorial Sloan Kettering Cancer Center, New York, NY.
authors.forename: Leontien C
authors.initials: LC
authors.lastname: Kremer
authors.affiliation: From the Department of Population Sciences, City of Hope, Duarte, CA; Department of Pediatric Oncology, Emma Children's Hospital/Academic Medical Center, Amsterdam, Netherlands; Department of Pediatrics, Memorial Sloan Kettering Cancer Center, New York, NY.
authors.forename: Charles
authors.initials: C
authors.lastname: Sklar
mesh_terms: D000367:Age Factors; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use; D002318:Cardiovascular Diseases / Q000209:etiology; D002648:Child; D017281:Cost of Illness; D004700:Endocrine System Diseases / Q000209:etiology; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects; D006801:Humans; D009369:Neoplasms / Q000150:complications* / Q000453:epidemiology / Q000628:therapy*; D016609:Neoplasms, Second Primary / Q000209:etiology; D011878:Radiotherapy / Q000009:adverse effects; D017741:Survivors