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Maurice-Stam H, van Erp LME, Maas A, van Oers HA, Kremer LCM, van Dulmen-den Broeder E, Tissing WJE, Loonen JJ, van der Pal HJH, Beek LR, de Vries ACH, van den Heuvel-Eibrink MM, Ronckers CM, Bresters D, Louwerens M, van der Heiden-van der Loo M, Huizinga GA, Grootenhuis MA. Psychosocial developmental milestones of young adult survivors of childhood cancer. Support Care Cancer 2022; 30:6839-6849. [PMID: 35538326 PMCID: PMC9213344 DOI: 10.1007/s00520-022-07113-3] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Accepted: 05/02/2022] [Indexed: 11/26/2022]
Abstract
PURPOSE The study aimed to compare the psychosocial development of young adult survivors of childhood cancer (YACCS) with a norm group of young adults from the general population. METHODS From 2017 to 2020, 558 YACCS (18-30 years, 51% female, 10.9% CNS cancer) who participated in the Dutch Childhood Cancer Survivor Study (DCCSS) LATER cohort (diagnosed 1963-2001) part 2 completed the Course of Life Questionnaire (CoLQ), assessing the achievement of milestones. Items were grouped into the scales autonomy, psychosexual, and social development. Differences between YACCS and norm group were examined with ANOVA and Cohen's d (CoLQ scales) and with logistic regression analysis and odds ratio (OR) (CoLQ items), for the total group and YACCS of CNS cancer. RESULTS The total group of YACCS did not report a less favorable psychosocial development than the norm group. YACCS of CNS cancer scored lower than the norm group (p < 0.001) on the scales autonomy (d = - 0.36) and psychosexual (d = - 0.46). Additionally, on half of the items of autonomy (0.25 ≤ OR ≤ 0.34), psychosexual (0.30 ≤ OR ≤ 0.48), and social (0.23 ≤ OR ≤ 0.47) development, YACCS of CNS cancer were less likely (p < 0.01) than the norm group to have achieved the milestones. CONCLUSION Overall, psychosocial development of YACCS was as favorable as the norm, but YACCS of CNS cancer were at risk of an unfavorable psychosocial development in all domains. Monitoring psychosocial development should be included in the standards of psychosocial care, especially for CNS cancer patients and survivors, to be able to trace delay. Personalized interventions should be offered to improve the psychosocial development in an early stage.
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Affiliation(s)
- Heleen Maurice-Stam
- Princess Máxima Center for Pediatric Oncology, Heidelberglaan 25, 3584 CS, Utrecht, The Netherlands.
| | - Loes M E van Erp
- Princess Máxima Center for Pediatric Oncology, Heidelberglaan 25, 3584 CS, Utrecht, The Netherlands
| | - Anne Maas
- Princess Máxima Center for Pediatric Oncology, Heidelberglaan 25, 3584 CS, Utrecht, The Netherlands
| | - Hedy A van Oers
- Department of Child and Adolescent Psychiatry and Psychosocial Care, Amsterdam Reproduction and Development, Amsterdam Public Health, Emma Children's Hospital, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Leontien C M Kremer
- Princess Máxima Center for Pediatric Oncology, Heidelberglaan 25, 3584 CS, Utrecht, The Netherlands
- Department of Pediatrics, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | | | - Wim J E Tissing
- Princess Máxima Center for Pediatric Oncology, Heidelberglaan 25, 3584 CS, Utrecht, The Netherlands
- Beatrix Children's Hospital/University of Groningen/University Medical Center Groningen, Groningen, The Netherlands
| | | | - Helena J H van der Pal
- Princess Máxima Center for Pediatric Oncology, Heidelberglaan 25, 3584 CS, Utrecht, The Netherlands
| | - Laura R Beek
- Princess Máxima Center for Pediatric Oncology, Heidelberglaan 25, 3584 CS, Utrecht, The Netherlands
| | - Andrica C H de Vries
- Princess Máxima Center for Pediatric Oncology, Heidelberglaan 25, 3584 CS, Utrecht, The Netherlands
- Sophia Children's Hospital/Erasmus Medical Center, Rotterdam, The Netherlands
| | - Marry M van den Heuvel-Eibrink
- Princess Máxima Center for Pediatric Oncology, Heidelberglaan 25, 3584 CS, Utrecht, The Netherlands
- Sophia Children's Hospital/Erasmus Medical Center, Rotterdam, The Netherlands
| | - Cécile M Ronckers
- Princess Máxima Center for Pediatric Oncology, Heidelberglaan 25, 3584 CS, Utrecht, The Netherlands
| | - Dorine Bresters
- Princess Máxima Center for Pediatric Oncology, Heidelberglaan 25, 3584 CS, Utrecht, The Netherlands
- Willem Alexander Children's Hospital/Leiden University Medical Center, Leiden, The Netherlands
| | | | | | - Gea A Huizinga
- Princess Máxima Center for Pediatric Oncology, Heidelberglaan 25, 3584 CS, Utrecht, The Netherlands
- Beatrix Children's Hospital/University of Groningen/University Medical Center Groningen, Groningen, The Netherlands
| | - Martha A Grootenhuis
- Princess Máxima Center for Pediatric Oncology, Heidelberglaan 25, 3584 CS, Utrecht, The Netherlands
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Hendriks MJ, Harju E, Roser K, Ienca M, Michel G. The long shadow of childhood cancer: a qualitative study on insurance hardship among survivors of childhood cancer. BMC Health Serv Res 2021; 21:503. [PMID: 34034742 PMCID: PMC8152348 DOI: 10.1186/s12913-021-06543-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2020] [Accepted: 04/23/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The long-term consequences of childhood cancer have received increasing attention due to the growing number of survivors over the past decades. However, insurance hardships of survivors are mostly unknown. This study explored qualitatively, in a sample of childhood cancer survivors (CCS), (i) the experiences and needs of CCS living in Switzerland with a special focus on hardships related to insurance; and (ii) the views of insurance and law experts with experience on childhood cancer. METHODS Semi-structured interviews were conducted with 28 childhood cancer survivors and 3 experts (one legal expert, two insurance experts). Data was analysed using qualitative content analysis. RESULTS Three key themes emerged from the interviews with the CCS: 1) experiences with insurance, 2) perception of discrimination, and 3) needs and barriers for support. The interviewed experts provided further detailed clarification of CCS' concerns. Our findings indicated that some CCS can move past their cancer history, while others continue to face hardships. CCS reported confusion about the opportunities and services within the social security system and most relied on their personal contacts for guidance. Finally, CCS expressed a strong need for socio-economic and legal support for social insurance questions, especially related to disability insurance. CONCLUSIONS With the growing population of CCS, it is essential to further assess the interplay between medical and psychosocial health and socio-economic hardship. Supportive psychosocial services should aim to ameliorate insurance hardships. Better understanding of the relationship between childhood cancer and insurance hardships during survivorship will inform efforts to improve long-term financial security and health outcomes for survivors. We call for the public, lawmakers, researchers, insurers, and patient organizations to come together and discuss future perspectives to avoid the risk of discrimination for cancer survivors.
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Affiliation(s)
- Manya Jerina Hendriks
- Department of Health Sciences and Medicine, University of Lucerne, Frohburgstrasse 3, PO Box 4466, 6002, Lucerne, Switzerland.,Clinical Ethics, Department of Neonatology, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Erika Harju
- Department of Health Sciences and Medicine, University of Lucerne, Frohburgstrasse 3, PO Box 4466, 6002, Lucerne, Switzerland
| | - Katharina Roser
- Department of Health Sciences and Medicine, University of Lucerne, Frohburgstrasse 3, PO Box 4466, 6002, Lucerne, Switzerland
| | - Marcello Ienca
- Department of Health Science and Technology, Technical University of Zurich, Zurich, Switzerland
| | - Gisela Michel
- Department of Health Sciences and Medicine, University of Lucerne, Frohburgstrasse 3, PO Box 4466, 6002, Lucerne, Switzerland.
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Maurice‐Stam H, Nijhof SL, Monninkhof AS, Heymans HSA, Grootenhuis MA. Review about the impact of growing up with a chronic disease showed delays achieving psychosocial milestones. Acta Paediatr 2019; 108:2157-2169. [PMID: 31250466 DOI: 10.1111/apa.14918] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/11/2019] [Revised: 06/11/2019] [Accepted: 06/26/2019] [Indexed: 01/02/2023]
Abstract
AIM This review aimed to provide a comprehensive overview of the psychosocial developmental trajectory of various diseases during childhood and adolescence. METHODS Studies of Dutch young adults aged 18-35 years, who had grown up with a chronic disease, were included if the Course of Life Questionnaire had been used to assess psychosocial developmental milestones in three domains: social, autonomy and psychosexual. Differences between the disease groups and the general population were presented as Cohen's d and odds ratios. RESULTS We included 17 studies comprising 1899 young adults, who had grown up with 18 different paediatric diseases. Psychosocial development was delayed in all three questionnaire domains. Remarkable findings with regard to specific milestones were as follows: less participation in sports clubs in the social domain, less likely to have had paid jobs in the autonomy domain and later sexual intimacy in the psychosexual domain. End-stage renal disease, galactosaemia (males), childhood cancer and orthotopic liver transplants were the most affected disease groups. CONCLUSION Children and adolescents with chronic diseases risked delays in psychosocial development. This should be addressed by healthcare providers, along with the physical aspects of diseases, and they should focus on the optimal psychosocial development of the patient.
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Affiliation(s)
- Heleen Maurice‐Stam
- Psychosocial Department Emma Children's Hospital Amsterdam University Medical Centers University of Amsterdam Amsterdam The Netherlands
| | - Sanne L. Nijhof
- Division of Paediatrics Wilhelmina Children's Hospital University Medical Center Utrecht Utrecht University Utrecht The Netherlands
| | - Anneke S. Monninkhof
- Division of Paediatrics Wilhelmina Children's Hospital University Medical Center Utrecht Utrecht University Utrecht The Netherlands
| | - Hugo S. A. Heymans
- Department of Paediatrics Emma Children's Hospital Amsterdam University Medical Centers University of Amsterdam Amsterdam The Netherlands
| | - Martha A. Grootenhuis
- Psychosocial Department Emma Children's Hospital Amsterdam University Medical Centers University of Amsterdam Amsterdam The Netherlands
- Princess Máxima Center for Paediatric Oncology Utrecht The Netherlands
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van der Pal SM, Maurice-Stam H, Grootenhuis MA, van Wassenaer-Leemhuis AG, Verrips GHW. Psychosocial developmental trajectory of a cohort of young adults born very preterm and/or with a very low birth weight in the Netherlands. J Patient Rep Outcomes 2019; 3:17. [PMID: 30847606 PMCID: PMC6405782 DOI: 10.1186/s41687-019-0106-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2018] [Accepted: 02/25/2019] [Indexed: 11/10/2022] Open
Abstract
Background The achievement of age-specific developmental milestones in youth is of great importance to the adjustment in adult life. Young adults who were born preterm, might go through a different developmental trajectory and transition into adulthood than their peers. This study aimed to compare the psychosocial developmental trajectory of young adults who were born preterm with peers from the general population. Young adults from the POPS (Project On Preterm and Small for gestational age infants) cohort study, born in 1983 in the Netherlands, completed online the Course of Life Questionnaire (CoLQ - achievement of psychosocial developmental milestones) at 28 years of age. Analysis of variance by group, age and gender was performed to test differences on the CoLQ scale scores between the POPS-group and 211 peers (25–30 years) from the general population (Ref-group). Differences on item level, representing the achievement of individual milestones, were analyzed with logistic regression analyses by group, age and gender. Results The POPS-group (n = 300, 32,3% biased response) scored significantly lower than the Ref-group on the scales Psychosexual Development (effect size − 0.26, p < 0.01), Antisocial Behavior (ES − 0.44, p < 0.001) and Substance Use & Gambling (ES − 0.35, p < .001). A further exploration on item-level revealed, among others, that the POPS-group had their first boyfriend/girlfriend at later age, were more often single, misbehaved less at school and smoked, drank and gambled less than the Ref-group. On the scales Autonomy Development and Social Development no differences were found between the POPS-group and the Ref-group. Conclusions A relatively less vulnerable respondent group of young adults born preterm showed some psychosocial developmental trajectory delays and might benefit from support at teenage age. Because of the non-response bias, we hypothesize that the total group of young adults born preterm will show more severe psychosocial developmental problems.
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Affiliation(s)
| | - Heleen Maurice-Stam
- Psychosocial Department, Emma Children's Hospital, University Medical Center, Amsterdam, Netherlands
| | - Martha A Grootenhuis
- Psychosocial Department, Emma Children's Hospital, University Medical Center, Amsterdam, Netherlands.,Princess Máxima Center for paediatric oncology, Utrecht, Netherlands
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Nicklin E, Velikova G, Hulme C, Rodriguez Lopez R, Glaser A, Kwok-Williams M, Boele F. Long-term issues and supportive care needs of adolescent and young adult childhood brain tumour survivors and their caregivers: A systematic review. Psychooncology 2019; 28:477-487. [DOI: 10.1002/pon.4989] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2018] [Revised: 12/28/2018] [Accepted: 01/11/2019] [Indexed: 12/21/2022]
Affiliation(s)
- Emma Nicklin
- Leeds Institute of Medical Research at St. James's, Faculty of Medicine and Health; University of Leeds; Leeds UK
| | - Galina Velikova
- Leeds Institute of Medical Research at St. James's, Faculty of Medicine and Health; University of Leeds; Leeds UK
| | - Claire Hulme
- Institute of Health Research; University of Exeter Medical School; Exeter UK
- Leeds Institute of Health Sciences, Faculty of Medicine and Health; University of Leeds; Leeds UK
| | - Rocio Rodriguez Lopez
- Leeds Institute of Health Sciences, Faculty of Medicine and Health; University of Leeds; Leeds UK
| | - Adam Glaser
- Leeds Institute of Medical Research at St. James's, Faculty of Medicine and Health; University of Leeds; Leeds UK
- Leeds Cancer Centre; Leeds Teaching Hospitals NHS Trust; Leeds UK
| | | | - Florien Boele
- Leeds Institute of Medical Research at St. James's, Faculty of Medicine and Health; University of Leeds; Leeds UK
- Leeds Institute of Health Sciences, Faculty of Medicine and Health; University of Leeds; Leeds UK
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Bal MI, Sattoe JN, Miedema HS, van Staa A. Social participation and psychosocial outcomes of young adults with chronic physical conditions: Comparing recipients and non-recipients of disability benefits. Ann Phys Rehabil Med 2018; 61:85-91. [DOI: 10.1016/j.rehab.2017.12.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2017] [Revised: 11/28/2017] [Accepted: 12/09/2017] [Indexed: 12/29/2022]
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Wu J, Dal Grande E, Winefield H, Broderick D, Pilkington R, Gill TK, Taylor AW. Parent-reported Mental Health Problems and Mental Health Services Use in South Australian School-aged Children. AIMS Public Health 2016; 3:750-768. [PMID: 29546193 PMCID: PMC5690403 DOI: 10.3934/publichealth.2016.4.750] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2016] [Accepted: 09/19/2016] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Monitoring and reporting childhood mental health problems and mental health services utilization over time provide important information to identify mental health related issues and to guide early intervention. This paper aims to describe the recent prevalence of parent-reported mental health problems among South Australian (SA) children; to identify mental health problems associated characteristics; and to describe mental health services utilization and its related characteristics among this population. METHODS Parent-reported mental health problems were assessed against the first item of the Strength and Difficulties Questionnaire. School-aged children were randomly sampled monthly and data were collected using a surveillance system between 2005 and 2015. Associations between mental health problems and various factors were analysed using univariable analysis and multivariable logistic regression modelling. RESULTS Prevalence of parent-reported mental health problems among children was 9.1% and 9.3% for children aged 5 to 11 years and children aged 12 to 15 years, respectively. No change in prevalence was observed during the past decade. Mental health problems were associated with male sex, long-term illness or pain, negative school experiences, not living with biological parents, and living in a rental dwelling. Less than half (48.7%) of the children with mental health problems received professional help. An increasing trend was found in mental health services utilisation among children aged 5 to 15 years. Utilization of mental health services was associated with male sex, older age, long-term illness or pain, and feeling unhappy at school. CONCLUSION This study reports the prevalence of parent-reported mental and mental health services utilisation among SA school-aged children. Identified characteristics associated with mental health problems and mental health services utilisation provide useful information for the planning of catered population initiatives.
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Affiliation(s)
- Jing Wu
- Population Research and Outcome Studies (PROS), School of Medicine, University of Adelaide, PO Box 498, Adelaide, South Australia 5001
| | - Eleonora Dal Grande
- Population Research and Outcome Studies (PROS), School of Medicine, University of Adelaide, PO Box 498, Adelaide, South Australia 5001
| | - Helen Winefield
- School of Psychology, University of Adelaide, South Australia 5005
| | | | | | - Tiffany K Gill
- Population Research and Outcome Studies (PROS), School of Medicine, University of Adelaide, PO Box 498, Adelaide, South Australia 5001
| | - Anne W Taylor
- Population Research and Outcome Studies (PROS), School of Medicine, University of Adelaide, PO Box 498, Adelaide, South Australia 5001
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Sattoe JNT, Hilberink SR, Peeters MAC, van Staa A. 'Skills for growing up': supporting autonomy in young people with kidney disease. J Ren Care 2013; 40:131-9. [PMID: 24373148 DOI: 10.1002/jorc.12046] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND OBJECTIVES End-stage kidney disease (ESKD) may interfere with children's developmental task of acquiring autonomy and participation. The Skills for Growing Up tool encourages normal development towards independence and autonomy during paediatric rehabilitation. This study aimed to adapt this self-management tool for use in paediatric nephrology, and to test whether its use is feasible in daily practice. DESIGN AND PARTICIPANTS A Delphi study was conducted among patients, their parents, professionals and experts to adjust the tool for use in nephrology. Feasibility was studied through individual and group interviews with professionals in all Dutch paediatric nephrology centres. RESULTS Agreement was reached on the areas of social participation and medical management of ESKD. Compared with the original, the new instrument holds considerable more attention for autonomy in the renal healthcare area; for example, dealing with medication and transplantation. Professionals used and appreciated the tool, but the paper form was seen to limit feasibility. CONCLUSIONS Making the tool available online is important. The challenge for professionals is to move beyond the focus on medical management and to consider developmental tasks when coaching their patients into adulthood. APPLICATION TO PRACTICE The Skills for Growing Up-Nephrology (SGU-N) tool is a promising instrument for use by professionals in paediatric nephrology. Its use can help young people achieving autonomy and may contribute to their successful transition to adulthood and adult care.
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Affiliation(s)
- Jane N T Sattoe
- Center of Expertise Innovations in Care, Rotterdam University, Rotterdam, The Netherlands; Institute of Health Policy and Management, Erasmus University Rotterdam, Rotterdam, The Netherlands
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Sattoe JNT, Jedeloo S, van Staa A. Effective peer-to-peer support for young people with end-stage renal disease: a mixed methods evaluation of Camp COOL. BMC Nephrol 2013; 14:279. [PMID: 24359407 PMCID: PMC3878094 DOI: 10.1186/1471-2369-14-279] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2013] [Accepted: 12/16/2013] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The Camp COOL programme aims to help young Dutch people with end-stage renal disease (ESRD) develop self-management skills. Fellow patients already treated in adult care (hereafter referred to as 'buddies') organise the day-to-day program, run the camp, counsel the attendees, and also participate in the activities. The attendees are young people who still have to transfer to adult care. This study aimed to explore the effects of this specific form of peer-to-peer support on the self-management of young people (16-25 years) with ESRD who participated in Camp COOL (CC) (hereafter referred to as 'participants'). METHODS A mixed methods research design was employed. Semi-structured interviews (n = 19) with initiators/staff, participants, and healthcare professionals were conducted. These were combined with retrospective and pre-post surveys among participants (n = 62), and observations during two camp weeks. RESULTS Self-reported effects of participants were: increased self-confidence, more disease-related knowledge, feeling capable of being more responsible and open towards others, and daring to stand up for yourself. According to participants, being a buddy or having one positively affected them. Self-efficacy of attendees and independence of buddies increased, while attendees' sense of social inclusion decreased (measured as domains of health-related quality of life). The buddy role was a pro-active combination of being supervisor, advisor, and leader. CONCLUSIONS Camp COOL allowed young people to support each other in adjusting to everyday life with ESRD. Participating in the camp positively influenced self-management in this group. Peer-to-peer support through buddies was much appreciated. Support from young adults was not only beneficial for adolescent attendees, but also for young adult buddies. Paediatric nephrologists are encouraged to refer patients to CC and to facilitate such initiatives. Together with nephrologists in adult care, they could take on a role in selecting buddies.
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Affiliation(s)
- Jane NT Sattoe
- Centre of Expertise Innovations in Care, Rotterdam University, P.O. Box 25035, 3001 HA Rotterdam, the Netherlands
- Institute of Health Policy & Management, Erasmus University Rotterdam, P.O. Box 1738, 3000 DR Rotterdam, the Netherlands
| | - Susan Jedeloo
- Centre of Expertise Innovations in Care, Rotterdam University, P.O. Box 25035, 3001 HA Rotterdam, the Netherlands
| | - AnneLoes van Staa
- Centre of Expertise Innovations in Care, Rotterdam University, P.O. Box 25035, 3001 HA Rotterdam, the Netherlands
- Institute of Health Policy & Management, Erasmus University Rotterdam, P.O. Box 1738, 3000 DR Rotterdam, the Netherlands
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Sieswerda E, Mulder RL, van Dijk IWEM, van Dalen EC, Knijnenburg SL, van der Pal HJH, Mud MS, Heinen RC, Caron HN, Kremer LCM. The EKZ/AMC childhood cancer survivor cohort: methodology, clinical characteristics, and data availability. J Cancer Surviv 2013; 7:439-54. [PMID: 23625157 DOI: 10.1007/s11764-013-0283-9] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2013] [Accepted: 03/25/2013] [Indexed: 12/28/2022]
Abstract
PURPOSE Childhood cancer survivors are at high risk of late adverse effects of cancer treatment, but there are still many gaps in evidence about these late effects. We described the methodology, clinical characteristics, data availability, and outcomes of our cohort study of childhood cancer survivors. METHODS The Emma Children's Hospital/Academic Medical Center (EKZ/AMC) childhood cancer survivor cohort is an ongoing single-center cohort study of ≥5-year childhood cancer survivors, which started in 1996 simultaneously with regular structured medical outcome assessments at our outpatient clinic. RESULTS From 1966 to 2003, 3,183 eligible children received primary cancer treatment in the EKZ/AMC, of which 1,822 (57.2 %) survived ≥5 years since diagnosis. Follow-up time ranged from 5.0 to 42.5 years (median, 17.7). Baseline primary cancer treatment characteristics were complete for 1,781 (97.7 %) survivors, and 1,452 (79.7 %) survivors visited our outpatient clinic. Baseline characteristics of survivors who visited the clinic did not differ from those without follow-up. Within our cohort, 54 studies have been conducted studying a wide range of late treatment-related effects. CONCLUSIONS The EKZ/AMC childhood cancer survivor cohort provides a strong structure for ongoing research on the late effects of childhood cancer treatment and will continuously contribute in reducing evidence gaps concerning risks and risk groups within this vulnerable population. IMPLICATIONS FOR CANCER SURVIVORS Our large cohort study of childhood cancer survivors with complete baseline characteristics and unique, long-term medical follow-up decreases gaps in evidence about specific risks of late effects and high-risk groups, with the ultimate goal of improving the quality of care for childhood cancer survivors.
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Affiliation(s)
- E Sieswerda
- Department of Pediatric Oncology, Emma Children's Hospital/Academic Medical Center, Amsterdam, The Netherlands.
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