Adult Life after Childhood Cancer in Scandinavia
Cancer and its treatment during childhood and adolescence (referred to as ‘childhood cancer’ in this webpage) can result in a variety of long-term sequelae, such as impairment of growth and development, reproductive difficulties, chronic late morbidity, second cancers, increased mortality and psychosocial and familial problems.
Studies of late sequelae of childhood cancer require a large population of survivors and long periods of follow-up if they are to yield reliable estimates of the relative and absolute risks. Combined, the Nordic countries are an ideal study area for this type of clinical/epidemiological research, as a broad range of health care data are available from high-quality, nationwide population registers.
By the end of 2009 the Danish Research Council decided to support the establishment of a large, retrospective, inter-Nordic childhood cancer cohort (n = 55 000) in order to compare their morbidity-specific incidence and cause-specific mortality with those of a sample of the general populations of the Nordic countries (n = 275 000). The approved study plan included three case-control studies which are nested in the cohort with the purpose of investigating associations, including dose-response, between specific treatment regimens and selected outcomes.
The types of late effects initially selected for case-cohort studies are
- cardiovascular and pulmonary diseases
- endocrine disorders and adverse reproductive outcomes
- renal and gastrointestinal disorders
- diabetes mellitus
The ultimate goals are to allow better planning of treatment protocols for Nordic childhood cancer patients, with fewer late effects, to contribute to preventive intervention strategies, to improve the basis for patient counseling and follow-up, and to educate a group of Nordic childhood oncologists/epidemiologists who become highly specialized in the prevention of late effects after treatment for childhood cancer.