Clinical Ascertainment of Health Outcomes in Asian Survivors of Childhood Cancer: A Systematic Review
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AbstractPurpose
Survivorship in children with cancer comes at a cost of developing chronic treatment-related complications. Yet, it is still an under-researched area in Asia, which shares the largest proportion of the global childhood cancer burden given its vast population. This systematic review summarizes existing literature on clinically ascertained health outcomes in Asian survivors of childhood cancer.

Methods
A search was conducted on Ovid Medline and EMBASE for studies that focused on survivors of childhood cancer from countries in East and Southeast Asia; adopted post-treatment clinical ascertainment of organ-specific toxicities or/and secondary malignancy. Studies were excluded if health outcomes were assessed during the acute treatment.

Results
Fifty-nine studies, enrolling a total of 13,442 subjects, were conducted on survivors of leukemia (34%), CNS tumor (14%), and cohorts of survivors with heterogeneous cancer diagnoses (52%). The studies used different medical evaluation methods to assess cardiovascular (15%), metabolic and infertility (32%), and neurological/neurocognitive (20%) outcomes in survivors. The collective findings suggest potential differences in the prevalence of certain late effects (e.g., secondary malignancy and obesity) among Asian and non-Asian populations, which may reflect differences in treatment regimens, practice, genetic variations, or/and socioeconomic disparity.

Conclusions
We recommend developing collaborative initiatives to build a regional repository of systematically assessed health outcomes and biospecimens to investigate treatment, social-environmental and genetic predictors, and interventions for late effects in this population.

Implications for Cancer Survivors
The existing types of chronic health problems identified in this review suggest the need for active screening, better access to survivorship care, and promotion of protective health behavior in Asia.
Acceptance Date05/04/2019
All Author(s) ListLong Hin Jonathan Poon, Chun-Pong Yu, Liwen Peng, Celeste Lom-Ying Ewig, Hui Zhang, Chi-Kong Li, Yin Ting Cheung
Journal nameJournal of Cancer Survivorship
Year2019
Month4
Day5
Volume Number13
Issue Number3
PublisherSpringer (part of Springer Nature): Springer Open Choice Hybrid Journals
Pages374 - 396
ISSN1932-2259
LanguagesEnglish-United States
KeywordsChildhood cancer, Late effects, Survivorship, Risk-based, Asian, Organ toxicity

Last updated on 2020-04-08 at 04:41