Survivors of childhood and adolescent cancer: life-long risks and responsibilities

Abstract

Survival rates for most paediatric cancers have improved at a remarkable pace over the past four decades. In developed countries, cure is now the probable outcome for most children and adolescents who are diagnosed with cancer: their 5-year survival rate approaches 80%. However, the vast majority of these cancer survivors will have at least one chronic health condition by 40 years of age. The burden of responsibility to understand the long-term morbidity and mortality that is associated with currently successful treatments must be borne by many, including the research and health care communities, survivor advocacy groups, and governmental and policy-making entities.

Figure 1

Age-specific cancer incidence rates, highlighting the small proportion represented by childhood/adolescent cancer patients (top graph). Improvements in overall survival among cancer patients diagnosed before the age of 20 years by year of cancer diagnosis (bottom graph). Source: Surveillance, Epidemiology, and End Results program of the National Cancer Institute.

Figure 2

Spectrum of health-related and quality of life outcomes among long-term survivors of childhood and adolescent cancers.

Figure 3

Theoretical framework regarding gaps in knowledge regarding the long-term outcomes among aging childhood and adolescent cancer survivors.

Figure 4

Inter-relationship of patient-, cancer-, health care system-, and provider-related issues impacting cancer treatment associated morbidity among long-term survivors of childhood and adolescent cancer.