The treatment of childhood cancer is one of oncology's great success stories. Most children and young adults under 20 years of age had little hope of cure prior to 1970. Since then, cure rates, as measured in five year survivals, have increased to 78 percent, largely as the result of the development of intensive multimodal treatments. The impressive gains in survival have been achieved at a price, however.
Only more recently has it been realized that the intense effort to care for and cure a child with cancer does not end with survival. Continued surveillance and a variety of interventions may, in many cases, be needed to identify and care for consequences of treatment that can appear early or only after several decades and impair survivors' health and quality of life.
The more than two-thirds of childhood cancer survivors who experience late effects -- that is, complications, disabilities, or adverse outcomes -- as a result of their disease, its treatment, or both, are the focus of this report, Childhood Cancer Survivorship: Improving Care and Quality of Life, which outlines a comprehensive policy agenda that links improved health care delivery and follow-up, investments in education and training for health care providers, and expanded research to improve the long-term outlook for this growing population now exceeding 270,000 Americans.