Comparison of self-reported late effects with medical records among survivors of childhood cancer

2010 ◽  
Vol 46 (6) ◽  
pp. 1069-1078 ◽  
Author(s):  
Naomi Taylor ◽  
Kate Absolom ◽  
Gisela Michel ◽  
Tanya Urquhart ◽  
Mary Gerrard ◽  
...  
Keyword(s):  
Childhood Cancer ◽  
Late Effects ◽  
Medical Records ◽  
Survivors Of Childhood Cancer

Late Effects in Survivors of Childhood Cancer

2006 ◽  
Vol 27 (7) ◽  
pp. 257-263
Author(s):  
Mandy M. Meck ◽  
Margaret Leary ◽  
Richard H. Sills
Keyword(s):  
Childhood Cancer ◽  
Late Effects ◽  
Survivors Of Childhood Cancer

scholarly journals Behavioral, Social, and Emotional Symptom Comorbidities and Profiles in Adolescent Survivors of Childhood Cancer: A Report From the Childhood Cancer Survivor Study

2016 ◽  
Vol 34 (28) ◽  
pp. 3417-3425 ◽  
Author(s):  
Tara M. Brinkman ◽  
Chenghong Li ◽  
Kathryn Vannatta ◽  
Jordan G. Marchak ◽  
Jin-Shei Lai ◽  
...  
Keyword(s):  
Childhood Cancer ◽  
Cancer Survivor ◽  
Late Effects ◽  
Externalizing Symptoms ◽  
Attention Problems ◽  
Childhood Cancer Survivor ◽  
Symptom Profiles ◽  
Increased Risk ◽  
Childhood Cancer Survivor Study ◽  
Survivors Of Childhood Cancer

Purpose In the general population, psychological symptoms frequently co-occur; however, profiles of symptom comorbidities have not been examined among adolescent survivors of childhood cancer. Patients and Methods Parents of 3,893 5-year survivors of childhood cancer who were treated between 1970 and 1999 and who were assessed in adolescence (age 12 to 17 years) completed the Behavior Problems Index. Age- and sex-standardized z scores were calculated for symptom domains by using the Childhood Cancer Survivor Study sibling cohort. Latent profile analysis identified profiles of comorbid symptoms, and multivariable multinomial logistic regression modeling examined associations between cancer treatment exposures and physical late effects and identified symptom profiles. Odds ratios (ORs) and 95% CIs for latent class membership were estimated and analyses were stratified by cranial radiation therapy (CRT; CRT or no CRT). Results Four symptoms profiles were identified: no significant symptoms (CRT, 63%; no CRT, 70%); elevated anxiety and/or depression, social withdrawal, and attention problems (internalizing; CRT, 31%; no CRT, 16%); elevated headstrong behavior and attention problems (externalizing; CRT, no observed; no CRT, 9%); and elevated internalizing and externalizing symptoms (global symptoms; CRT, 6%; no CRT, 5%). Treatment with ≥ 30 Gy CRT conferred greater risk of internalizing (OR, 1.7; 95% CI, 1.0 to 2.8) and global symptoms (OR, 3.2; 95% CI, 1.2 to 8.4). Among the no CRT group, corticosteroid treatment was associated with externalizing symptoms (OR, 1.9; 95% CI, 1.2 to 2.8) and ≥ 4.3 g/m2 intravenous methotrexate exposure was associated with global symptoms (OR, 1.5; 95% CI, 0.9 to 2.4). Treatment late effects, including obesity, cancer-related pain, and sensory impairments, were significantly associated with increased risk of comorbid symptoms. Conclusion Behavioral, emotional, and social symptoms frequently co-occur in adolescent survivors of childhood cancer and are associated with treatment exposures and physical late effects. Assessment and consideration of symptom profiles are essential for directing appropriate mental health treatment for adolescent survivors.

scholarly journals Cost-Effectiveness of the International Late Effects of Childhood Cancer Guideline Harmonization Group Screening Guidelines to Prevent Heart Failure in Survivors of Childhood Cancer

2020 ◽  
Vol 38 (33) ◽  
pp. 3851-3862 ◽  
Author(s):  
Matthew J. Ehrhardt ◽  
Zachary J. Ward ◽  
Qi Liu ◽  
Aeysha Chaudhry ◽  
Anju Nohria ◽  
...  
Keyword(s):  
Heart Failure ◽  
Cost Effectiveness ◽  
High Risk ◽  
Childhood Cancer ◽  
Late Effects ◽  
Cost Effective ◽  
Risk Groups ◽  
Low Risk ◽  
Moderate Risk ◽  
Survivors Of Childhood Cancer

PURPOSE Survivors of childhood cancer treated with anthracyclines and/or chest-directed radiation are at increased risk for heart failure (HF). The International Late Effects of Childhood Cancer Guideline Harmonization Group (IGHG) recommends risk-based screening echocardiograms, but evidence supporting its frequency and cost-effectiveness is limited. PATIENTS AND METHODS Using the Childhood Cancer Survivor Study and St Jude Lifetime Cohort, we developed a microsimulation model of the clinical course of HF. We estimated long-term health outcomes and economic impact of screening according to IGHG-defined risk groups (low [doxorubicin-equivalent anthracycline dose of 1-99 mg/m2 and/or radiotherapy < 15 Gy], moderate [100 to < 250 mg/m2 or 15 to < 35 Gy], or high [≥ 250 mg/m2 or ≥ 35 Gy or both ≥ 100 mg/m2 and ≥ 15 Gy]). We compared 1-, 2-, 5-, and 10-year interval-based screening with no screening. Screening performance and treatment effectiveness were estimated based on published studies. Costs and quality-of-life weights were based on national averages and published reports. Outcomes included lifetime HF risk, quality-adjusted life-years (QALYs), lifetime costs, and incremental cost-effectiveness ratios (ICERs). Strategies with ICERs < $100,000 per QALY gained were considered cost-effective. RESULTS Among the IGHG risk groups, cumulative lifetime risks of HF without screening were 36.7% (high risk), 24.7% (moderate risk), and 16.9% (low risk). Routine screening reduced this risk by 4% to 11%, depending on frequency. Screening every 2, 5, and 10 years was cost-effective for high-risk survivors, and every 5 and 10 years for moderate-risk survivors. In contrast, ICERs were > $175,000 per QALY gained for all strategies for low-risk survivors, representing approximately 40% of those for whom screening is currently recommended. CONCLUSION Our findings suggest that refinement of recommended screening strategies for IGHG high- and low-risk survivors is needed, including careful reconsideration of discontinuing asymptomatic left ventricular dysfunction and HF screening in low-risk survivors.

scholarly journals Grading of late effects in young adult survivors of childhood cancer followed in an ambulatory adult setting

Cancer ◽  
2000 ◽  
Vol 88 (7) ◽  
pp. 1687-1695 ◽  
Author(s):  
Kevin C. Oeffinger ◽  
Debra A. Eshelman ◽  
Gail E. Tomlinson ◽  
George R. Buchanan ◽  
Barbara M. Foster
Keyword(s):  
Young Adult ◽  
Childhood Cancer ◽  
Late Effects ◽  
Adult Survivors ◽  
Young Adult Survivors ◽  
Survivors Of Childhood Cancer

scholarly journals A Systematic Review of Selected Musculoskeletal Late Effects in Survivors of Childhood Cancer

2015 ◽  
Vol 10 (4) ◽  
pp. 249-262 ◽  
Author(s):  
Prasad Gawade ◽  
Melissa Hudson ◽  
Sue Kaste ◽  
Joseph Neglia ◽  
Karen Wasilewski- Masker ◽  
...  
Keyword(s):  
Systematic Review ◽  
Childhood Cancer ◽  
Late Effects ◽  
Survivors Of Childhood Cancer

scholarly journals A Comparison of Late Mortality Among Survivors of Childhood Cancer in the United States and United Kingdom

2020 ◽  
Author(s):  
Miranda M Fidler-Benaoudia ◽  
Kevin C Oeffinger ◽  
Yutaka Yasui ◽  
Leslie L Robison ◽  
David L Winter ◽  
...  
Keyword(s):  
Childhood Cancer ◽  
Cancer Survivor ◽  
Late Effects ◽  
Childhood Cancer Survivor ◽  
Lower Probability ◽  
Standardized Mortality Ratio ◽  
Late Mortality ◽  
Mortality Ratio ◽  
Childhood Cancer Survivor Study ◽  
Survivors Of Childhood Cancer

Abstract Background It is unclear whether late-effect risks among childhood cancer survivors vary internationally. We compared late mortality in the North American Childhood Cancer Survivor Study (CCSS) and British Childhood Cancer Survivor Study (BCCSS). Methods Late mortality was assessed among 49 822 5-year survivors of childhood cancer diagnosed before 15 years of age from 1970 to 1999 (CCSS, n = 31 596; BCCSS, n = 18 226) using cumulative mortality probabilities (CM%) and adjusted ratios of the standardized mortality ratio. Results The all-cause CM% at 10 years from diagnosis was statistically significantly lower in the CCSS (4.7%, 95% confidence interval [CI] = 4.5% to 5.0%) compared with the BCCSS (6.9%, 95% CI = 6.5% to 7.2%), attributable to a lower probability of death from recurrence or progression of the primary cancer, with statistically significant differences observed in survivors of leukemia, lymphoma, central nervous system tumors, and sarcoma. However, at 40 years from diagnosis, the CCSS had a greater CM% (22.3% vs 19.3%), attributable to a twofold higher risk of mortality from subsequent malignant neoplasms, cardiac and respiratory diseases, and other health-related causes. Differences increased when assessed by follow-up interval, with the CCSS faring worse as time-since-diagnosis increased. Finally, the gap in all-cause mortality widened more recently, with CCSS survivors diagnosed in 1990-1999 experiencing one-half the excess deaths observed in the BCCSS (ratios of the standardized mortality ratio = 0.5, 95% CI = 0.5 to 0.6). Conclusions Our findings suggest that US survivors may have received more intensive regimens to achieve sustainable remission and cure, but the cost of this approach was a higher risk of death from late effects. Although the clinical impact of these differences is unclear, our results provide important evidence to aid the discussion of late effects management.

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