title: Yield of Urinalysis Screening in Pediatric Cancer Survivors.
abstract: BACKGROUND
  The Children's Oncology Group (COG) publishes consensus guidelines with screening recommendations for early identification of treatment-related morbidities among childhood cancer survivors. We sought to estimate the yield of recommended yearly urinalysis screening for genitourinary complications as per Version 3.0 of the COG Long-Term Follow-Up Guidelines and identify possible risk factors for abnormal screening in a survivor population.
  
  
  METHODS
  A database of pediatric cancer survivors evaluated between January 2008 and March 2012 at Children's Healthcare of Atlanta was queried for survivors at risk for genitourinary late effects. The frequency of abnormal urinalyses (protein ≥1+ and/or presence of glucose and/or ≥5 red blood cells per high power field) was estimated. Risk factors associated with abnormal screening were identified.
  
  
  RESULTS
  Chart review identified 773 survivors (57% male; 67% Caucasian; 60% leukemia/lymphoma survivors; mean age at diagnosis, 5.7 years [range: birth to 17.7 years]; time from diagnosis to initial screening, 7.6 years [range: 2.3 to 21.5 years]) who underwent urinalysis. Abnormal results were found in 78 (5.3%) of 1,484 total urinalyses. Multivariable analysis revealed higher dose ifosfamide (odds ratio [OR] = 6.8, 95% confidence interval [CI] 2.9-16.0) and total body irradiation (TBI, OR = 3.0, 95% CI 1.0-8.4) as significant risk factors for abnormal initial urinalysis screening.
  
  
  CONCLUSIONS
  Pediatric cancer survivors exposed to higher dose ifosfamide or TBI may be at higher risk of abnormal findings on urinalysis screening. Targeted screening of these higher risk patients should be considered.
authors.affiliation: Department of Pediatrics, Emory University School of Medicine, Atlanta, Georgia.|The Aflac Cancer and Blood Disorders Center at Children's Healthcare of Atlanta, Atlanta, Georgia.
authors.forename: Matthew D
authors.initials: MD
authors.lastname: Ramirez
authors.affiliation: Department of Pediatrics, Emory University School of Medicine, Atlanta, Georgia.|The Aflac Cancer and Blood Disorders Center at Children's Healthcare of Atlanta, Atlanta, Georgia.
authors.forename: Ann C
authors.initials: AC
authors.lastname: Mertens
authors.affiliation: Department of Radiation Oncology, Emory University School of Medicine, Atlanta, Georgia.
authors.forename: Natia
authors.initials: N
authors.lastname: Esiashvili
authors.affiliation: Department of Pediatrics, Emory University School of Medicine, Atlanta, Georgia.|The Aflac Cancer and Blood Disorders Center at Children's Healthcare of Atlanta, Atlanta, Georgia.
authors.forename: Lillian R
authors.initials: LR
authors.lastname: Meacham
authors.affiliation: Department of Pediatrics, Emory University School of Medicine, Atlanta, Georgia.|The Aflac Cancer and Blood Disorders Center at Children's Healthcare of Atlanta, Atlanta, Georgia.
authors.forename: Karen
authors.initials: K
authors.lastname: Wasilewski-Masker
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D016208:Databases, Factual; D005260:Female; D005500:Follow-Up Studies; D006029:Glycosuria / Q000139:chemically induced / Q000652:urine*; D006417:Hematuria / Q000139:chemically induced / Q000652:urine*; D006801:Humans; D007069:Ifosfamide / Q000008:administration & dosage / Q000009:adverse effects; D007938:Leukemia / Q000188:drug therapy / Q000401:mortality / Q000652:urine; D008223:Lymphoma / Q000188:drug therapy / Q000401:mortality / Q000652:urine; D008297:Male; D011507:Proteinuria / Q000139:chemically induced / Q000652:urine*; D012307:Risk Factors; D017741:Survivors; D016482:Urinalysis
chemical_list: D007069:Ifosfamide
keywords: adverse effect; childhood cancer; genitourinary; ifosfamide; whole body irradiation