Originally published as JCO Early Release 10.1200/JCO.2004.11.032 on December 2 2004

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Development of Risk-Based Guidelines for Pediatric Cancer Survivors: The Children's Oncology Group Long-Term Follow-Up Guidelines From the Children's Oncology Group Late Effects Committee and Nursing Discipline

From the Division of Pediatrics, City of Hope Comprehensive Cancer Center, Duarte; Department of Pediatric Hematology-Oncology, Stanford University Medical Center, Stanford; Division of Hematology-Oncology, Department of Pediatrics, USC Keck School of Medicine and Children's Hospital Los Angeles, CA; Center for Cancer and Blood Disorders, Children's Medical Center; Department of Family Practice and Community Medicine, University of Texas Southwestern Medical School, Dallas, TX; Division of Pediatric Oncology, AFLAC Cancer Center and Blood Disorders Service, Children's Healthcare of Atlanta, Atlanta, GA; Department of Hematology-Oncology, St. Jude Children's Research Hospital, Memphis, TN; Children's Oncology Group Patient Advocacy Committee, Lincoln, NE; Department of Pediatrics, University of Miami School of Medicine, Miami, FL; Division of Pediatric Hematology-Oncology, University of North Carolina, Chapel Hill, NC; Department of Radiation Oncology, University of Rochester Medical Center, Rochester; Department of Pediatrics, Roswell Park Cancer Institute, Buffalo; Department of Pediatrics/Endocrinology, Memorial Sloan Kettering Cancer Center, New York, NY; Department of Radiation Oncology, McGill University Health Centre, Montréal, Québec, Canada; Department of Pediatric Hematology-Oncology, Children's Hospital and Regional Medical Center, Seattle, WA; Division of Oncology, Children's Hospital of Philadelphia, Philadelphia, PA; and Department of Pediatrics, University of Minnesota School of Medicine, Minneapolis, MN

Address reprint requests to Melissa M. Hudson, MD, St Jude Children's Research Hospital, 332 N Lauderdale, Memphis, Tennessee 38105; e-mail: melissa.hudson{at}stjude.org

The Children’s Oncology Group Long-Term Follow-Up Guidelines for Survivors of Childhood, Adolescent, and Young Adult Cancers are risk-based, exposure-related clinical practice guidelines intended to promote earlier detection of and intervention for complications that may potentially arise as a result of treatment for pediatric malignancies. Developed through the collaborative efforts of the Children’s Oncology Group Late Effects Committee, Nursing Discipline, and Patient Advocacy Committee, these guidelines represent a statement of consensus from a multidisciplinary panel of experts in the late effects of pediatric cancer treatment. The guidelines are both evidence-based (utilizing established associations between therapeutic exposures and late effects to identify high-risk categories) and grounded in the collective clinical experience of experts (matching the magnitude of risk with the intensity of screening recommendations). They are intended for use beginning 2 or more years following the completion of cancer therapy; however, they are not intended to provide guidance for follow-up of the survivor’s primary disease. A complementary set of patient education materials ("Health Links") was developed to enhance follow-up care and broaden the application of the guidelines. The information provided in these guidelines is important for health care providers in the fields of pediatrics, oncology, internal medicine, family practice, and gynecology, as well as subspecialists in many fields. Implementation of these guidelines is intended to increase awareness of potential late effects and to standardize and enhance follow-up care provided to survivors of pediatric cancer throughout the lifespan. The Guidelines, and related Health Links, can be downloaded in their entirety at www.survivorshipguidelines.org.

Supported by the Children's Oncology Group grant U10 CA098543 from the National Cancer Institute. Dr Hudson is also supported by the Cancer Center Support (CORE) grant CA 21765 from the National Cancer Institute and by the American Lebanese Syrian Associated Charities.

Authors' disclosures of potential conflicts of interest are found at the end of this article.

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