Risk stratification of childhood cancer survivors necessary for evidence-based clinical long term follow-up

This study provides the first large-scale investigation into the long term risks of serious adverse health outcomes associated with the National Cancer Survivorship Initiative (NCSI) Levels of clinical care in a cohort of childhood cancer survivors. Clinical follow-up care was based on cancer type and treatment and ranged from Level 1 (supported self-care) to Level 3 (consultant-led care). The study investigated risks of specific causes of death, subsequent primary neoplasms (SPNs) and non-fatal non-neoplastic outcomes by NCSI Level. Overall cumulative risks of any adverse health outcome by 45 years from diagnosis assigned to NCSI Levels 1, 2 and 3 were 21%, 45% and 69% respectively. The NCSI risk stratification tool provides a clear and strong discrimination between survivors assigned to the three different NSCI Levels of care.

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