Endocrine Abstracts

A third of UK residents develop cancer, but the risk of being diagnosed under age 50 years is under 4%. The four most common cancers account for 54% of all cases: breast (16%), lung (13%), colorectal (13%) and prostate (12%). Five-year age standardised survival has increased substantially in recent decades for breast, prostate and colorectal cancer resulting in latest figures of 77, 65 and 48%, respectively. Cancer is increasingly becoming a curable or chronic disease. At the end of 2008 there were 2 000 000 cancer survivors in the UK, about 3.3% of the total population, including 10% of all people aged at least 65 years.

An area of oncology, which has produced some of the greatest improvements in survival across recent decades, is paediatric oncology. Only 25% of those diagnosed in the 1960s survived at least 5-years compared to 75% of those diagnosed in the 1990s. About 15 years ago it became increasingly clear that large-scale epidemiological studies (ideally population-based) needed to be undertaken involving direct contact with survivors and addressing a wide spectrum of health and social outcomes which might be adversely affected by childhood cancer or its treatment. This work complements smaller clinical studies involving individual patient measurements, sometimes including tissue and fluid sampling.

To date two such large-scale and comprehensive epidemiological studies have been established: the US Childhood Cancer Survivor Study (USCCSS) and the British Childhood Cancer Survivor Study (BCCSS). The BCCSS comprises 18 000 individuals diagnosed with childhood cancer between 1940 and 1991, in Britain, and surviving at least 5 years. The entire population-based cohort of 18 000 form the basis of studies of causes of death and subsequent primary neoplasms. Of the 14 800 eligible to receive a questionnaire, 10 500 (71%) returned it completed. Evidence gained from previous clinical and epidemiological studies of childhood cancer survivors will be reviewed.