Promoting Health and Care Transitions in the Long-Term AYA Survivor

  • Melissa Maria HudsonEmail author
  • Karen Kinahan
  • Lisa K. Sharp
  • David R. Freyer
Part of the Pediatric Oncology book series (PEDIATRICO)


A large proportion of survivors of cancer diagnosed when they were AYAs experience some adverse effects on their health, some that do not become apparent for years or even decades after the exposure to the anticancer therapies. The developing and maturing organ systems of AYAs have different sensitivities to radiation therapy, chemotherapy, and surgery than do those of younger or older cancer patients. Virtually all organ systems can be affected, depending upon the therapeutic exposure, leading to a wide array of late effects, including second cancers, cardiovascular and pulmonary disease, cognitive dysfunction, and musculoskeletal problems. Some initially subclinical effects may exacerbate common diseases associated with aging, such as cardiovascular, skeletal, and endocrine disorders, and contribute to poor quality of life and premature death. Sociodemographic factors, details of treatment, and health behaviors also influence the magnitude of impairment in specific health status domains. Through risk-based care and education about the health risks conferred by the cancer experience, clinicians caring for long-term survivors play a critical role in the prevention, diagnosis, and rehabilitation of cancer-related complications and adjustment to chronic health conditions predisposed or exacerbated by cancer. Consequently, health professionals caring for AYA cancer survivors may influence their future health positively by correcting knowledge deficits, addressing factors that enhance an individual survivor’s vulnerability to health problems, and providing personalized health counseling that promotes the practice of health-promoting behaviors. This chapter describes the healthcare of survivors of cancer diagnosed during the AYA years, including risk-based screening and surveillance for late effects, transition of AYA healthcare, and models of AYA survivorship care. The promotion of healthy lifestyle habits is discussed, emphasizing the impact of such habits on the expression of late effects.


Cancer Survivor Hodgkin Lymphoma Childhood Cancer Survivor Indoor Tanning Young Adult Cancer Survivor 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.



Dr. Hudson is supported by a Cancer Center Support (CORE) Grant CA 21765 from the National Cancer Institute and by the American Lebanese Syrian Associated Charities (ALSAC). Dr. Freyer is supported by National Cancer Institute grant U10 CA98543 and by funds from the COG and Aflac Foundations.


  1. 1.
    Nass SJ et al (2015) Identifying and addressing the needs of adolescents and young adults with cancer: summary of an Institute of Medicine workshop. Oncologist 20:186–195PubMedPubMedCentralCrossRefGoogle Scholar
  2. 2.
    Robison LL, Hudson MM (2014) Survivors of childhood and adolescent cancer: life-long risks and responsibilities. Nat Rev Cancer 14:61–70PubMedCrossRefGoogle Scholar
  3. 3.
    Armstrong GT et al (2014) Aging and risk of severe, disabling, life-threatening, and fatal events in the childhood cancer survivor study. J Clin Oncol 32:1218–1227PubMedPubMedCentralCrossRefGoogle Scholar
  4. 4.
    Brignardello E et al (2013) Endocrine health conditions in adult survivors of childhood cancer: the need for specialized adult-focused follow-up clinics. Eur J Endocrinol 168:465–472PubMedCrossRefGoogle Scholar
  5. 5.
    Chemaitilly W et al (2015) Anterior hypopituitarism in adult survivors of childhood cancers treated with cranial radiotherapy: a report from the St Jude lifetime cohort study. J Clin Oncol 33:492–500PubMedPubMedCentralCrossRefGoogle Scholar
  6. 6.
    Hudson MM et al (2013) Clinical ascertainment of health outcomes among adults treated for childhood cancer. JAMA 309:2371–2381PubMedPubMedCentralCrossRefGoogle Scholar
  7. 7.
    Reulen RC et al (2011) Long-term risks of subsequent primary neoplasms among survivors of childhood cancer. JAMA 305:2311–2319PubMedCrossRefGoogle Scholar
  8. 8.
    Schellong G et al (2010) Late valvular and other cardiac diseases after different doses of mediastinal radiotherapy for Hodgkin disease in children and adolescents: report from the longitudinal GPOH follow-up project of the German-Austrian DAL-HD studies. Pediatr Blood Cancer 55:1145–1152PubMedCrossRefGoogle Scholar
  9. 9.
    van der Pal HJ et al (2012) High risk of symptomatic cardiac events in childhood cancer survivors. J Clin Oncol 30:1429–1437PubMedCrossRefGoogle Scholar
  10. 10.
    Armstrong GT et al (2013) Modifiable risk factors and major cardiac events among adult survivors of childhood cancer. J Clin Oncol 31:3673–3680PubMedPubMedCentralCrossRefGoogle Scholar
  11. 11.
    Reulen RC et al (2010) Long-term cause-specific mortality among survivors of childhood cancer. JAMA 304:172–179PubMedCrossRefGoogle Scholar
  12. 12.
    Hudson MM et al (2015) Age-dependent changes in health status in the childhood cancer survivor cohort. J Clin Oncol 33:479–491PubMedCrossRefGoogle Scholar
  13. 13.
    Hudson MM (2005) A model for care across the cancer continuum. Cancer 104:2638–2642PubMedCrossRefGoogle Scholar
  14. 14.
    Edgar AB et al (2013) Can intensity of long-term follow-up for survivors of childhood and teenage cancer be determined by therapy-based risk stratification? BMJ Open 3:e002451. doi: 10.1136/bmjopen-2012-002451
  15. 15.
    McCabe MS et al (2013) Risk-based health care, the cancer survivor, the oncologist, and the primary care physician. Semin Oncol 40:804–812PubMedPubMedCentralCrossRefGoogle Scholar
  16. 16.
    Oeffinger KC (2003) Longitudinal risk-based health care for adult survivors of childhood cancer. Curr Probl Cancer 27:143–167PubMedCrossRefGoogle Scholar
  17. 17.
    Freyer DR (2010) Transition of care for young adult survivors of childhood and adolescent cancer: rationale and approaches. J Clin Oncol 28:4810–4818PubMedPubMedCentralCrossRefGoogle Scholar
  18. 18.
    Eshelman-Kent D et al (2011) Cancer survivorship practices, services, and delivery: a report from the Children’s Oncology Group (COG) nursing discipline, adolescent/young adult, and late effects committees. J Cancer Surviv 5:345–357PubMedPubMedCentralCrossRefGoogle Scholar
  19. 19.
    Ristovski-Slijepcevic S et al (2009) A cross-Canada survey of clinical programs for the care of survivors of cancer in childhood and adolescence. Paediatr Child Health 14:375–378PubMedPubMedCentralGoogle Scholar
  20. 20.
  21. 21.
    Kremer LC et al (2013) A worldwide collaboration to harmonize guidelines for the long-term follow-up of childhood and young adult cancer survivors: a report from the International Late Effects of Childhood Cancer Guideline Harmonization Group. Pediatr Blood Cancer 60:543–549PubMedCrossRefGoogle Scholar
  22. 22.
    Mulrooney DA et al (2014) Coronary artery disease detected by coronary computed tomography angiography in adult survivors of childhood Hodgkin lymphoma. Cancer 120:3536–3544PubMedPubMedCentralCrossRefGoogle Scholar
  23. 23.
    Mulder RL et al (2013) Recommendations for breast cancer surveillance for female survivors of childhood, adolescent, and young adult cancer given chest radiation: a report from the International Late Effects of Childhood Cancer Guideline Harmonization Group. Lancet Oncol 14:e621–e629PubMedPubMedCentralCrossRefGoogle Scholar
  24. 24.
    Oeffinger KC et al (2009) Breast cancer surveillance practices among women previously treated with chest radiation for a childhood cancer. JAMA 301:404–414PubMedPubMedCentralCrossRefGoogle Scholar
  25. 25.
    Pan PH, Moore CH (2002) Doxorubicin-induced cardiomyopathy during pregnancy: three case reports of anesthetic management for cesarean and vaginal delivery in two kyphoscoliotic patients. Anesthesiology 97:513–515PubMedCrossRefGoogle Scholar
  26. 26.
    Eshelman D et al (2004) Facilitating care for childhood cancer survivors: integrating children’s oncology group long-term follow-up guidelines and health links in clinical practice. J Pediatr Oncol Nurs 21:271–280PubMedCrossRefGoogle Scholar
  27. 27.
    Phelps RG et al (2014) Patients’ continuing use of an online health record: a quantitative evaluation of 14,000 patient years of access data. J Med Internet Res 16:e241PubMedPubMedCentralCrossRefGoogle Scholar
  28. 28.
    Kuijpers W et al (2015) An interactive portal to empower cancer survivors: a qualitative study on user expectations. Support Care Cancer 23(9):2535–2542. doi:  10.1007/s00520-015-2605-0. Epub 2015 Jan 27
  29. 29.
    Hayes-Lattin B, Mathews-Bradshaw B, Siegel S (2010) Adolescent and young adult oncology training for health professionals: a position statement. J Clin Oncol 28:4858–4861PubMedCrossRefGoogle Scholar
  30. 30.
    Stein DM et al (2014) Fertility preservation preferences and perspectives among adult male survivors of pediatric cancer and their parents. J Adolesc Young Adult Oncol 3:75–82PubMedPubMedCentralCrossRefGoogle Scholar
  31. 31.
    Howlader N et al (2015) SEER cancer statistics review, 1975–2012, National Cancer Institute,, based on Nov 2014 SEER data submission, posted to the SEER web site, Apr 2015
  32. 32.
    Nathan PC et al (2011) Critical issues in transition and survivorship for adolescents and young adults with cancers. Cancer 117:2335–2341PubMedCrossRefGoogle Scholar
  33. 33.
    Oeffinger KC, Tonorezos ES (2011) The cancer is over, now what?: understanding risk, changing outcomes. Cancer 117:2250–2257PubMedCrossRefGoogle Scholar
  34. 34.
    Bleyer A (2005) The adolescent and young adult gap in cancer care and outcome. Curr Probl Pediatr Adolesc Health Care 35:182–217PubMedCrossRefGoogle Scholar
  35. 35.
    Kadan-Lottick NS et al (2002) Childhood cancer survivors’ knowledge about their past diagnosis and treatment: childhood cancer survivor study. JAMA 287:1832–1839PubMedCrossRefGoogle Scholar
  36. 36.
    Nathan PC et al (2008) Medical care in long-term survivors of childhood cancer: a report from the childhood cancer survivor study. J Clin Oncol 26:4401–4409PubMedPubMedCentralCrossRefGoogle Scholar
  37. 37.
    Hewitt M, Greenfield S, Stovall E (2006) From cancer patient to cancer survivor: lost in transition. The National Academies Press, Washington, DCGoogle Scholar
  38. 38.
    Coccia PF et al (2012) Adolescent and young adult oncology. Clinical practice guidelines in oncology. J Natl Compr Canc Netw 10:1112–1150PubMedCrossRefGoogle Scholar
  39. 39.
    American Society of Clinical Oncology (2014) The state of cancer care in America. J Oncol Pract 10:119–142CrossRefGoogle Scholar
  40. 40.
    American Society of Clinical, Oncology Focus Under Forty (2014)
  41. 41.
    Armenian SH et al (2015) Recommendations for cardiomyopathy surveillance for survivors of childhood cancer: a report from the International Late Effects of Childhood Cancer Guideline Harmonization Group. Lancet Oncol 16:e123–e136PubMedPubMedCentralCrossRefGoogle Scholar
  42. 42.
    Bower JE et al (2014) Screening, assessment, and management of fatigue in adult survivors of cancer: an American Society of Clinical oncology clinical practice guideline adaptation. J Clin Oncol 32:1840–1850PubMedPubMedCentralCrossRefGoogle Scholar
  43. 43.
    Hershman DL et al (2014) Prevention and management of chemotherapy-induced peripheral neuropathy in survivors of adult cancers: American Society of Clinical Oncology clinical practice guideline. J Clin Oncol 32:1941–1967PubMedCrossRefGoogle Scholar
  44. 44.
    Landier W et al (2004) 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. J Clin Oncol 22:4979–4990PubMedCrossRefGoogle Scholar
  45. 45.
    Loren AW et al (2013) Fertility preservation for patients with cancer: American Society of Clinical Oncology clinical practice guideline update. J Clin Oncol 31:2500–2510PubMedPubMedCentralCrossRefGoogle Scholar
  46. 46.
    Oeffinger KC et al (2004) Health care of young adult survivors of childhood cancer: a report from the childhood cancer survivor study. Ann Fam Med 2:61–70PubMedPubMedCentralCrossRefGoogle Scholar
  47. 47.
    Friedman DL, Freyer DR, Levitt GA (2006) Models of care for survivors of childhood cancer. Pediatr Blood Cancer 46:159–168PubMedCrossRefGoogle Scholar
  48. 48.
    Mulder RL et al (2011) Pulmonary function impairment measured by pulmonary function tests in long-term survivors of childhood cancer. Thorax 66:1065–1071PubMedCrossRefGoogle Scholar
  49. 49.
    Reulen RC et al (2007) Health-status of adult survivors of childhood cancer: a large-scale population-based study from the British childhood cancer survivor study. Int J Cancer 121:633–640PubMedCrossRefGoogle Scholar
  50. 50.
    Hawkins MM et al (2008) The British childhood cancer survivor study: objectives, methods, population structure, response rates and initial descriptive information. Pediatr Blood Cancer 50:1018–1025PubMedCrossRefGoogle Scholar
  51. 51.
    Castellino SM et al (2011) Morbidity and mortality in long-term survivors of Hodgkin lymphoma: a report from the childhood cancer survivor study. Blood 117:1806–1816PubMedPubMedCentralCrossRefGoogle Scholar
  52. 52.
    Robison LL et al (2009) The childhood cancer survivor study: a National Cancer Institute-supported resource for outcome and intervention research. J Clin Oncol 27:2308–2318PubMedPubMedCentralCrossRefGoogle Scholar
  53. 53.
    Sieswerda E et al (2013) The EKZ/AMC childhood cancer survivor cohort: methodology, clinical characteristics, and data availability. J Cancer Surviv 7:439–454PubMedCrossRefGoogle Scholar
  54. 54.
    American College of Surgeons Commission on Cancer (2012) Cancer program standards 2012: ensuring patient-centered care, standard 3.3:78.
  55. 55.
    American Society of Clinical Oncology (2014) ASCO survivorship compendium.
  56. 56.
    Oeffinger KC, McCabe MS (2006) Models for delivering survivorship care. J Clin Oncol 24:5117–5124PubMedCrossRefGoogle Scholar
  57. 57.
    Oeffinger KC, Hudson MM, Landier W (2009) Survivorship: childhood cancer survivors. Prim Care 36:743–780PubMedCrossRefGoogle Scholar
  58. 58.
    Suh E et al (2014) General internists’ preferences and knowledge about the care of adult survivors of childhood cancer: a cross-sectional survey. Ann Intern Med 160:11–17PubMedPubMedCentralCrossRefGoogle Scholar
  59. 59.
    Ciardullo AV et al (2003) Changes in long-term glycemic control and performance indicators in a cohort of type 2 diabetic patients cared for by general practitioners: findings from the “Modena Diabetes Project”. Nutr Metab Cardiovasc Dis 13:372–376PubMedCrossRefGoogle Scholar
  60. 60.
    Jones C et al (2006) An evaluation of a shared primary and secondary care nephrology service for managing patients with moderate to advanced CKD. Am J Kidney Dis 47:103–114PubMedCrossRefGoogle Scholar
  61. 61.
    Scherpbier-de Haan ND et al (2013) Effect of shared care on blood pressure in patients with chronic kidney disease: a cluster randomised controlled trial. Br J Gen Pract 63:e798–e806PubMedPubMedCentralCrossRefGoogle Scholar
  62. 62.
    Blaauwbroek R et al (2008) Shared care by paediatric oncologists and family doctors for long-term follow-up of adult childhood cancer survivors: a pilot study. Lancet Oncol 9:232–238PubMedCrossRefGoogle Scholar
  63. 63.
    Nekhlyudov L (2014) Integrating primary care in cancer survivorship programs: models of care for a growing patient population. Oncologist 19:579–582PubMedPubMedCentralCrossRefGoogle Scholar
  64. 64.
    Hong S et al (2009) Cancer survivorship care: exploring the role of the general internist. J Gen Intern Med 24(Suppl 2):S495–S500PubMedCrossRefGoogle Scholar
  65. 65.
    Jones LW et al (2014) Exercise and risk of major cardiovascular events in adult survivors of childhood hodgkin lymphoma: a report from the childhood cancer survivor study. J Clin Oncol 32:3643–3650PubMedPubMedCentralCrossRefGoogle Scholar
  66. 66.
    Oancea SC et al (2014) Cigarette smoking and pulmonary function in adult survivors of childhood cancer exposed to pulmonary-toxic therapy: results from the St. Jude lifetime cohort study. Cancer Epidemiol Biomarkers Prev 23:1938–1943PubMedPubMedCentralCrossRefGoogle Scholar
  67. 67.
    Smith WA et al (2014) Lifestyle and metabolic syndrome in adult survivors of childhood cancer: a report from the St. Jude lifetime cohort study. Cancer 120:2742–2750PubMedPubMedCentralCrossRefGoogle Scholar
  68. 68.
    Tyc VL, Hudson MM, Hinds P (1999) Health promotion interventions for adolescent cancer survivors. Cogn Behav Pract 6:128–136CrossRefGoogle Scholar
  69. 69.
    Brouwer CA et al (2012) Body mass index and annual increase of body mass index in long-term childhood cancer survivors; relationship to treatment. Support Care Cancer 20:311–318PubMedCrossRefGoogle Scholar
  70. 70.
    Garmey EG et al (2008) Longitudinal changes in obesity and body mass index among adult survivors of childhood acute lymphoblastic leukemia: a report from the childhood cancer survivor study. J Clin Oncol 26:4639–4645PubMedPubMedCentralCrossRefGoogle Scholar
  71. 71.
    Blair SN et al (1996) Influences of cardiorespiratory fitness and other precursors on cardiovascular disease and all-cause mortality in men and women. JAMA 276:205–210PubMedCrossRefGoogle Scholar
  72. 72.
    Hoffman KE et al (2008) Metabolic syndrome traits in long-term survivors of pediatric sarcoma. Pediatr Blood Cancer 50:341–346PubMedCrossRefGoogle Scholar
  73. 73.
    Slater ME et al (2015) Physical activity, fitness, and cardiometabolic risk factors in adult survivors of childhood cancer with a history of hematopoietic cell transplantation. Biol Blood Marrow Transpl 21:1278–1283Google Scholar
  74. 74.
    Tillmann V et al (2002) Male sex and low physical activity are associated with reduced spine bone mineral density in survivors of childhood acute lymphoblastic leukemia. J Bone Miner Res 17:1073–1080PubMedCrossRefGoogle Scholar
  75. 75.
    van der Sluis IM, van den Heuvel-Eibrink MM (2008) Osteoporosis in children with cancer. Pediatr Blood Cancer 50:474–478; discussion 486PubMedCrossRefGoogle Scholar
  76. 76.
    Green DM et al (2012) Risk factors for obesity in adult survivors of childhood cancer: a report from the childhood cancer survivor study. J Clin Oncol 30:246–255PubMedCrossRefGoogle Scholar
  77. 77.
    Demark-Wahnefried W et al (2005) Survivors of childhood cancer and their guardians. Cancer 103:2171–2180PubMedCrossRefGoogle Scholar
  78. 78.
    Keats MR et al (2006) An examination of physical activity behaviors in a sample of adolescent cancer survivors. J Pediatr Oncol Nurs 23:135–142PubMedCrossRefGoogle Scholar
  79. 79.
    Landy DC et al (2013) Dietary quality, caloric intake, and adiposity of childhood cancer survivors and their siblings: an analysis from the cardiac risk factors in childhood cancer survivors study. Nutr Cancer 65:547–555PubMedCrossRefGoogle Scholar
  80. 80.
    Nottage KA et al (2014) Metabolic syndrome and cardiovascular risk among long-term survivors of acute lymphoblastic leukaemia—from the St. Jude lifetime cohort. Br J Haematol 165:364–374PubMedPubMedCentralCrossRefGoogle Scholar
  81. 81.
    Reeves M et al (2007) Health behaviours in survivors of childhood cancer. Aust Fam Physician 36:95–96PubMedGoogle Scholar
  82. 82.
    Robien K et al (2008) Poor adherence to dietary guidelines among adult survivors of childhood acute lymphoblastic leukemia. J Pediatr Hematol Oncol 30:815–822PubMedPubMedCentralCrossRefGoogle Scholar
  83. 83.
    Stolley MR, Restrepo J, Sharp LK (2010) Diet and physical activity in childhood cancer survivors: a review of the literature. Ann Behav Med 39:232–249PubMedPubMedCentralCrossRefGoogle Scholar
  84. 84.
    Harz KJ et al (2003) Obesity in patients with craniopharyngioma: assessment of food intake and movement counts indicating physical activity. J Clin Endocrinol Metab 88:5227–5231PubMedCrossRefGoogle Scholar
  85. 85.
    Mayer EI et al (2000) Energy expenditure, energy intake and prevalence of obesity after therapy for acute lymphoblastic leukemia during childhood. Horm Res 53:193–199PubMedGoogle Scholar
  86. 86.
    Warner JT et al (1998) Daily energy expenditure and physical activity in survivors of childhood malignancy. Pediatr Res 43:607–613PubMedCrossRefGoogle Scholar
  87. 87.
    Kadan-Lottick N et al (2001) Normal bone mineral density after treatment for childhood acute lymphoblastic leukemia diagnosed between 1991 and 1998. J Pediatr 138:898–904PubMedCrossRefGoogle Scholar
  88. 88.
    Nysom K et al (1998) Bone mass and body composition after cessation of therapy for childhood cancer. Int J Cancer Suppl 11:40–43PubMedCrossRefGoogle Scholar
  89. 89.
    van der Sluis IM et al (2002) Altered bone mineral density and body composition, and increased fracture risk in childhood acute lymphoblastic leukemia. J Pediatr 141:204–210PubMedCrossRefGoogle Scholar
  90. 90.
    Oeffinger KC et al (2001) Cardiovascular risk factors in young adult survivors of childhood acute lymphoblastic leukemia. J Pediatr Hematol Oncol 23:424–430PubMedCrossRefGoogle Scholar
  91. 91.
    Stolley MR et al (2015) Health behaviors of minority childhood cancer survivors. Cancer;121:1671–1680Google Scholar
  92. 92.
    Smith WA et al (2014) Exercise training in childhood cancer survivors with subclinical cardiomyopathy who were treated with anthracyclines. Pediatr Blood Cancer 61:942–945Google Scholar
  93. 93.
    Kelly AK (2011) Physical activity prescription for childhood cancer survivors. Curr Sports Med Rep 10:352–359PubMedCrossRefGoogle Scholar
  94. 94.
    Haskell WL et al (2007) Physical activity and public health: updated recommendation for adults from the American College of Sports Medicine and the American Heart Association. Circulation 116:1081–1093PubMedCrossRefGoogle Scholar
  95. 95.
    Smith WA et al (2014) Measured versus self-reported physical function in adult survivors of childhood cancer. Med Sci Sports Exerc 46:211–218PubMedPubMedCentralCrossRefGoogle Scholar
  96. 96.
    Nathan PC et al (2009) Health behaviors, medical care, and interventions to promote healthy living in the childhood cancer survivor study cohort. J Clin Oncol 27:2363–2373PubMedPubMedCentralCrossRefGoogle Scholar
  97. 97.
    Cox CL et al (2009) Promoting physical activity in childhood cancer survivors: results from the childhood cancer survivor study. Cancer 115:642–654PubMedPubMedCentralCrossRefGoogle Scholar
  98. 98.
    Friedenreich CM (2001) Physical activity and cancer prevention: from observational to intervention research. Cancer Epidemiol Biomarkers Prev 10:287–301PubMedGoogle Scholar
  99. 99.
    Glade MJ (1999) Food, nutrition, and the prevention of cancer: a global perspective. American Institute for Cancer Research/World Cancer Research Fund, American Institute for Cancer Research, 1997. Nutrition 15:523–526PubMedCrossRefGoogle Scholar
  100. 100.
    Kushi LH et al (2012) American cancer society guidelines on nutrition and physical activity for cancer prevention: reducing the risk of cancer with healthy food choices and physical activity. CA Cancer J Clin 62:30–67PubMedCrossRefGoogle Scholar
  101. 101.
    Eckel RH et al (2014) 2013 AHA/ACC guideline on lifestyle management to reduce cardiovascular risk: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. J Am Coll Cardiol 63:2960–2984PubMedCrossRefGoogle Scholar
  102. 102.
    Office of Disease Prevention and Health Promotion, U.S. Department of Health and Human Services (2015) Scientific Report of the 2015 Dietary Guidelines Advisory Committee,
  103. 103.
    Slavin JL (2000) Mechanisms for the impact of whole grain foods on cancer risk. J Am Coll Nutr 19:300S–307SPubMedCrossRefGoogle Scholar
  104. 104.
    Monninkhof EM et al (2007) Physical activity and breast cancer: a systematic review. Epidemiology 18:137–157PubMedCrossRefGoogle Scholar
  105. 105.
    Voskuil DW et al (2007) Physical activity and endometrial cancer risk, a systematic review of current evidence. Cancer Epidemiol Biomarkers Prev 16:639–648PubMedCrossRefGoogle Scholar
  106. 106.
    Wolin KY et al (2009) Physical activity and colon cancer prevention: a meta-analysis. Br J Cancer 100:611–616PubMedPubMedCentralCrossRefGoogle Scholar
  107. 107.
    Verloop J et al (2000) Physical activity and breast cancer risk in women aged 20–54 years. J Natl Cancer Inst 92:128–135PubMedCrossRefGoogle Scholar
  108. 108.
    Okada M et al (2012) Exercise recommendations for childhood cancer survivors exposed to cardiotoxic therapies: an institutional clinical practice initiative. J Pediatr Oncol Nurs 29:246–252PubMedCrossRefGoogle Scholar
  109. 109.
    Children’s Oncology Group long-term follow-up guidelines for survivors of childhood, adolescent and young adult cancers, version 4.0 (2013)
  110. 110.
    Cigarette smoking among childhood cancer survivors (1988) Am J Dis Child 142:123–124Google Scholar
  111. 111.
    Haupt R et al (1992) Smoking habits in survivors of childhood and adolescent cancer. Med Pediatr Oncol 20:301–306PubMedCrossRefGoogle Scholar
  112. 112.
    Emmons K et al (2002) Predictors of smoking initiation and cessation among childhood cancer survivors: a report from the childhood cancer survivor study. J Clin Oncol 20:1608–1616PubMedCrossRefGoogle Scholar
  113. 113.
    Emmons KM et al (2003) Smoking among participants in the childhood cancer survivors cohort: the partnership for health study. J Clin Oncol 21:189–196PubMedCrossRefGoogle Scholar
  114. 114.
    Larcombe I, Mott M, Hunt L (2002) Lifestyle behaviours of young adult survivors of childhood cancer. Br J Cancer 87:1204–1209PubMedPubMedCentralCrossRefGoogle Scholar
  115. 115.
    Tao ML et al (1998) Smoking in adult survivors of childhood acute lymphoblastic leukemia. J Natl Cancer Inst 90:219–225PubMedCrossRefGoogle Scholar
  116. 116.
    Frobisher C et al (2008) Extent of smoking and age at initiation of smoking among adult survivors of childhood cancer in Britain. J Natl Cancer Inst 100:1068–1081PubMedCrossRefGoogle Scholar
  117. 117.
    Kahalley LS et al (2012) Risk factors for smoking among adolescent survivors of childhood cancer: a report from the childhood cancer survivor study. Pediatr Blood Cancer 58:428–434PubMedCrossRefGoogle Scholar
  118. 118.
    Boivin JF (1995) Smoking, treatment for Hodgkin’s disease, and subsequent lung cancer risk. J Natl Cancer Inst 87:1502–1503PubMedCrossRefGoogle Scholar
  119. 119.
    Kaldor JM et al (1992) Lung cancer following Hodgkin’s disease: a case-control study. Int J Cancer 52:677–681PubMedCrossRefGoogle Scholar
  120. 120.
    van Leeuwen FE et al (1995) Roles of radiotherapy and smoking in lung cancer following Hodgkin’s disease. J Natl Cancer Inst 87:1530–1537PubMedCrossRefGoogle Scholar
  121. 121.
    Frobisher C et al (2010) Extent of alcohol consumption among adult survivors of childhood cancer: the British childhood cancer survivor study. Cancer Epidemiol Biomarkers Prev 19:1174–1184PubMedCrossRefGoogle Scholar
  122. 122.
    Hollen PJ et al (2007) Substance use risk behaviors and decision-making skills among cancer-surviving adolescents. J Pediatr Oncol Nurs 24:264–273PubMedCrossRefGoogle Scholar
  123. 123.
    Klosky JL et al (2012) Risky health behavior among adolescents in the childhood cancer survivor study cohort. J Pediatr Psychol 37:634–646PubMedPubMedCentralCrossRefGoogle Scholar
  124. 124.
    Lown EA et al (2008) Alcohol consumption patterns and risk factors among childhood cancer survivors compared to siblings and general population peers. Addiction 103:1139–1148PubMedPubMedCentralCrossRefGoogle Scholar
  125. 125.
    Rebholz CE et al (2012) Alcohol consumption and binge drinking in young adult childhood cancer survivors. Pediatr Blood Cancer 58:256–264PubMedCrossRefGoogle Scholar
  126. 126.
    Castellino S et al (2010) Hepato-biliary late effects in survivors of childhood and adolescent cancer: a report from the Children’s Oncology Group. Pediatr Blood Cancer 54:663–669PubMedPubMedCentralGoogle Scholar
  127. 127.
    Castellino S et al (2004) The epidemiology of chronic hepatitis C infection in survivors of childhood cancer: an update of the St Jude Children’s Research Hospital hepatitis C seropositive cohort. Blood 103:2460–2466PubMedCrossRefGoogle Scholar
  128. 128.
    Cesaro S et al (2010) An updated follow-up of chronic hepatitis C after three decades of observation in pediatric patients cured of malignancy. Pediatr Blood Cancer 55:108–112PubMedGoogle Scholar
  129. 129.
    Fink FM et al (1993) Association of hepatitis C virus infection with chronic liver disease in paediatric cancer patients. Eur J Pediatr 152:490–492PubMedCrossRefGoogle Scholar
  130. 130.
    Fioredda F et al (2010) Natural course of HCV infection in childhood cancer survivors. Support Care Cancer 18:1413–1420PubMedCrossRefGoogle Scholar
  131. 131.
    Locasciulli A et al (1997) Prevalence and natural history of hepatitis C infection in patients cured of childhood leukemia. Blood 90:4628–4633PubMedGoogle Scholar
  132. 132.
    Neilson JR et al (1996) Chronic hepatitis C in long term survivors of haematological malignancy treated in a single centre. J Clin Pathol 49:230–232PubMedPubMedCentralCrossRefGoogle Scholar
  133. 133.
    Paul IM et al (1999) Chronic hepatitis C virus infections in leukemia survivors: prevalence, viral load, and severity of liver disease. Blood 93:3672–3677PubMedGoogle Scholar
  134. 134.
    Shalmani HM, Ranjbar M, Alizadeh AHM (2013) Recommendations for prevention and control of hepatitis C virus (HCV) infection and HCV-related chronic disease. J Liver 3:147. doi: 10.4172/2167-0889.1000147
  135. 135.
    Socie G, de Latour RP, McDonald GB (2009) Hepatitis C virus and allogeneic stem cell transplantation still matters! Haematologica 94:170–172PubMedPubMedCentralCrossRefGoogle Scholar
  136. 136.
    de Ville de Goyet M et al (2013) Iron overload in children undergoing cancer treatments. Pediatr Blood Cancer 60:1982–1987PubMedCrossRefGoogle Scholar
  137. 137.
    Ruccione KS et al (2014) Characterization of transfusion-derived iron deposition in childhood cancer survivors. Cancer Epidemiol Biomarkers Prev 23:1913–1919PubMedCrossRefGoogle Scholar
  138. 138.
    Agrawal S, Bonkovsky HL (2002) Management of nonalcoholic steatohepatitis: an analytic review. J Clin Gastroenterol 35:253–261PubMedCrossRefGoogle Scholar
  139. 139.
    Pascale A, Pais R, Ratziu V (2010) An overview of nonalcoholic steatohepatitis: past, present and future directions. J Gastrointestin Liver Dis 19:415–423PubMedGoogle Scholar
  140. 140.
    Bagnardi V et al (2015) Alcohol consumption and site-specific cancer risk: a comprehensive dose-response meta-analysis. Br J Cancer 112:580–593PubMedCrossRefGoogle Scholar
  141. 141.
    O’Keefe JH, Bybee KA, Lavie CJ (2007) Alcohol and cardiovascular health: the razor-sharp double-edged sword. J Am Coll Cardiol 50:1009–1014PubMedCrossRefGoogle Scholar
  142. 142.
    Simard EP et al (2012) Cancers with increasing incidence trends in the United States: 1999 through 2008. CA Cancer J Clin 62:118–128PubMedCrossRefGoogle Scholar
  143. 143.
    Braam KI et al (2012) Malignant melanoma as second malignant neoplasm in long-term childhood cancer survivors: a systematic review. Pediatr Blood Cancer 58:665–674PubMedCrossRefGoogle Scholar
  144. 144.
    Pappo AS et al (2013) Melanoma as a subsequent neoplasm in adult survivors of childhood cancer: a report from the childhood cancer survivor study. Pediatr Blood Cancer 60:461–466PubMedCrossRefGoogle Scholar
  145. 145.
    Perkins JL et al (2005) Nonmelanoma skin cancer in survivors of childhood and adolescent cancer: a report from the childhood cancer survivor study. J Clin Oncol 23:3733–3741PubMedCrossRefGoogle Scholar
  146. 146.
    Koh HK et al (1996) Prevention and early detection strategies for melanoma and skin cancer. Current status. Arch Dermatol 132:436–443PubMedCrossRefGoogle Scholar
  147. 147.
    Rhodes AR (1995) Public education and cancer of the skin. What do people need to know about melanoma and nonmelanoma skin cancer? Cancer 75:613–636PubMedCrossRefGoogle Scholar
  148. 148.
    Centers for Disease Control and Prevention (2015) What can i do to reduce my risk of skin cancer?
  149. 149.
    Dahllof G (2008) Oral and dental late effects after pediatric stem cell transplantation. Biol Blood Marrow Transplant 14:81–83PubMedCrossRefGoogle Scholar
  150. 150.
    Effinger KE et al (2014) Oral and dental late effects in survivors of childhood cancer: a Children’s Oncology Group report. Support Care Cancer 22:2009–2019PubMedPubMedCentralCrossRefGoogle Scholar
  151. 151.
    Gawade PL et al (2014) A systematic review of dental late effects in survivors of childhood cancer. Pediatr Blood Cancer 61:407–416PubMedCrossRefGoogle Scholar
  152. 152.
    Kaste SC et al (2009) Impact of radiation and chemotherapy on risk of dental abnormalities: a report from the childhood cancer survivor study. Cancer 115:5817–5827PubMedPubMedCentralCrossRefGoogle Scholar
  153. 153.
    Wogelius P et al (2008) A population-based observational study of dental caries among survivors of childhood cancer. Pediatr Blood Cancer 50:1221–1226PubMedCrossRefGoogle Scholar
  154. 154.
    Yeazel MW et al (2004) An examination of the dental utilization practices of adult survivors of childhood cancer: a report from the childhood cancer survivor study. J Public Health Dent 64:50–54PubMedCrossRefGoogle Scholar

Copyright information

© Springer International Publishing 2017

Authors and Affiliations

  • Melissa Maria Hudson
    • 1
    Email author
  • Karen Kinahan
    • 2
  • Lisa K. Sharp
    • 3
  • David R. Freyer
    • 4
  1. 1.Division of Cancer Survivorship, Department of OncologySt. Jude Children’s Research HospitalMemphisUSA
  2. 2.Supportive OncologyRobert H. Lurie Comprehensive Cancer Center of Northwestern UniversityChicagoUSA
  3. 3.Section of Health Promotion, Department of MedicineUniversity of IllinoisChicagoUSA
  4. 4.Division of Hematology, Oncology, and Blood & Marrow TransplantationChildren’s Hospital Los AngelesLos AngelesUSA

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