Long-term follow-up of pediatric cancer survivors: education, surveillance, and screening

Pediatr Blood Cancer. 2006 Feb;46(2):149-58. doi: 10.1002/pbc.20612.


Cancer and its treatment predispose childhood cancer survivors to chronic or late occurring health problems that may not become clinically significant until many years after therapy. Frequently, long-term survivors of childhood cancer report late cancer-related effects that diminish quality of life and increase the risk of early mortality. Risk-based health care that involves a personalized plan for surveillance, screening, and prevention is recommended to reduce cancer-related morbidity in childhood cancer survivors. To implement optimal risk-based care, the survivor and health care provider must have accurate information about cancer diagnosis, treatment modalities, and potential cancer-related health risks to guide screening and risk-reducing interventions. However, previous studies evaluating health knowledge of childhood cancer survivors demonstrate noteworthy deficits and misperceptions about their cancer diagnosis, treatment, and cancer-related health risks. In addition, because of the relative rarity of childhood cancer, many health care providers lack familiarity with cancer-related health risks and risk-reduction methods relevant for this population. To correct these deficits, the Scottish Intercollegiate Guidelines Network (SIGN) and the Children's Oncology Group (COG) developed clinical practice guidelines to foster appropriate risk-based survivor care. Herein, we discuss the development, benefits, and limitations of the SIGN and COG guidelines and the foundation they provide for standardizing long-term follow-up care of the ever-growing vulnerable population of childhood cancer survivors.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Aftercare* / economics
  • Aftercare* / organization & administration
  • Aftercare* / trends
  • Child
  • Child, Preschool
  • Delivery of Health Care* / economics
  • Delivery of Health Care* / organization & administration
  • Delivery of Health Care* / trends
  • Disease-Free Survival
  • Female
  • Follow-Up Studies
  • Guideline Adherence / economics
  • Guideline Adherence / standards
  • Guideline Adherence / trends
  • Humans
  • Infant
  • Male
  • Mass Screening / economics
  • Mass Screening / organization & administration
  • Mass Screening / trends
  • Neoplasms* / economics
  • Neoplasms* / mortality
  • Neoplasms* / psychology
  • Neoplasms* / therapy
  • Patient Education as Topic* / organization & administration
  • Patient Education as Topic* / standards
  • Practice Guidelines as Topic / standards
  • Quality Assurance, Health Care* / economics
  • Quality Assurance, Health Care* / organization & administration
  • Quality Assurance, Health Care* / trends
  • Quality of Life
  • Risk Factors