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Surveillance for late effects in childhood cancer survivors

Landier, Wendy ; Skinner, Roderick ; Wallace, W. Hamish ; Hjorth, Lars LU ; Mulder, Renée L. ; Wong, F. Lennie ; Yasui, Yutaka ; Bhakta, Nickhill ; Constine, Louis S. and Bhatia, Smita , et al. (2018) In Journal of Clinical Oncology 36(21). p.2216-2222
Abstract

Many childhood cancer survivors carry a significant risk for late morbidity and mortality, a consequence of the numerous therapeutic exposures that contribute to their cure. Focused surveillance for late therapy-related complications provides opportunities for early detection and implementation of health-preserving interventions. The substantial body of research that links therapeutic exposures used during treatment of childhood cancer to adverse outcomes among survivors enables the characterization of groups at the highest risk for developing complications related to specific therapies; however, methods available to optimize screening strategies to detect these therapy-related complications are limited. Moreover, the feasibility of... (More)

Many childhood cancer survivors carry a significant risk for late morbidity and mortality, a consequence of the numerous therapeutic exposures that contribute to their cure. Focused surveillance for late therapy-related complications provides opportunities for early detection and implementation of health-preserving interventions. The substantial body of research that links therapeutic exposures used during treatment of childhood cancer to adverse outcomes among survivors enables the characterization of groups at the highest risk for developing complications related to specific therapies; however, methods available to optimize screening strategies to detect these therapy-related complications are limited. Moreover, the feasibility of conducting clinical trials to test screening recommendations for childhood cancer survivors is limited by requirements for large sample sizes, lengthy study periods, prohibitive costs, and ethical concerns. In addition, the harms of screening should be considered, including overdiagnosis and psychological distress. Experts in several countries have developed guideline recommendations for late effects surveillance and have collaborated to harmonize these recommendations internationally to enhance long-term follow-up care and quality of life for childhood cancer survivors. Methods used in these international efforts include systematic literature searches, development of evidence-based summaries, rigorous evaluation of the evidence, and formulation of consensus-based surveillance recommendations for each late complication. Alternate methods to refine recommendations, such as cumulative burden assessment and risk prediction and cost-effectiveness modeling, may provide novel approaches to guide survivorship care in this vulnerable population and, thus, represents a worthy objective for future international survivorship collaborations.

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published
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Journal of Clinical Oncology
volume
36
issue
21
pages
7 pages
publisher
American Society of Clinical Oncology
external identifiers
  • scopus:85050150982
  • pmid:29874139
ISSN
0732-183X
DOI
10.1200/JCO.2017.77.0180
language
English
LU publication?
yes
id
ac6d7acd-aa15-4b9e-b101-cf03232625dd
date added to LUP
2018-08-21 10:47:15
date last changed
2020-04-02 02:02:54
@article{ac6d7acd-aa15-4b9e-b101-cf03232625dd,
  abstract     = {<p>Many childhood cancer survivors carry a significant risk for late morbidity and mortality, a consequence of the numerous therapeutic exposures that contribute to their cure. Focused surveillance for late therapy-related complications provides opportunities for early detection and implementation of health-preserving interventions. The substantial body of research that links therapeutic exposures used during treatment of childhood cancer to adverse outcomes among survivors enables the characterization of groups at the highest risk for developing complications related to specific therapies; however, methods available to optimize screening strategies to detect these therapy-related complications are limited. Moreover, the feasibility of conducting clinical trials to test screening recommendations for childhood cancer survivors is limited by requirements for large sample sizes, lengthy study periods, prohibitive costs, and ethical concerns. In addition, the harms of screening should be considered, including overdiagnosis and psychological distress. Experts in several countries have developed guideline recommendations for late effects surveillance and have collaborated to harmonize these recommendations internationally to enhance long-term follow-up care and quality of life for childhood cancer survivors. Methods used in these international efforts include systematic literature searches, development of evidence-based summaries, rigorous evaluation of the evidence, and formulation of consensus-based surveillance recommendations for each late complication. Alternate methods to refine recommendations, such as cumulative burden assessment and risk prediction and cost-effectiveness modeling, may provide novel approaches to guide survivorship care in this vulnerable population and, thus, represents a worthy objective for future international survivorship collaborations.</p>},
  author       = {Landier, Wendy and Skinner, Roderick and Wallace, W. Hamish and Hjorth, Lars and Mulder, Renée L. and Wong, F. Lennie and Yasui, Yutaka and Bhakta, Nickhill and Constine, Louis S. and Bhatia, Smita and Kremer, Leontien C. and Hudson, Melissa M.},
  issn         = {0732-183X},
  language     = {eng},
  month        = {07},
  number       = {21},
  pages        = {2216--2222},
  publisher    = {American Society of Clinical Oncology},
  series       = {Journal of Clinical Oncology},
  title        = {Surveillance for late effects in childhood cancer survivors},
  url          = {http://dx.doi.org/10.1200/JCO.2017.77.0180},
  doi          = {10.1200/JCO.2017.77.0180},
  volume       = {36},
  year         = {2018},
}