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Добірка наукової літератури з теми "Survivors of childhood cancers"

Автор: Grafiati

Опубліковано: 15 лютого 2025

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Статті в журналах з теми "Survivors of childhood cancers"

Recklitis, Christopher J., Lisa R. Diller, Xiaochun Li, Julie Najita, Leslie L. Robison, and Lonnie Zeltzer. "Suicide Ideation in Adult Survivors of Childhood Cancer: A Report From the Childhood Cancer Survivor Study." Journal of Clinical Oncology 28, no. 4 (February 1, 2010): 655–61. http://dx.doi.org/10.1200/jco.2009.22.8635.

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Purpose To evaluate risk of suicide ideation (SI) after childhood cancer, prevalence of SI in a cohort of adult survivors of pediatric cancers was compared with prevalence in a sibling comparison group. The relationship of SI to cancer treatment and current health was examined, and the hypothesis that poor physical health is significantly associated with suicidality, after adjusting for depression, was specifically tested. Methods Nine thousand one hundred twenty-six adult survivors of childhood cancer and 2,968 siblings enrolled onto the Childhood Cancer Survivor Study completed a survey describing their demographics and medical and psychological functioning, including SI in the prior week. Results Of survivors, 7.8% reported SI compared with 4.6% of controls (odds ratio = 1.79; 95% CI, 1.4 to 2.4). Suicidality was unrelated to age, age at diagnosis, sex, cancer therapy, recurrence, time since diagnosis, or second malignancy. SI was associated with primary CNS cancer diagnosis, depression, and poor health outcomes including chronic conditions, pain, and poor global health rating. A logistic regression analysis showed that poor current physical health was significantly associated with SI even after adjusting for cancer diagnosis and depression. Conclusion Adult survivors of childhood cancers are at increased risk for SI. Risk of SI is related to cancer diagnosis and post-treatment mental and physical health, even many years after completion of therapy. The association of suicidal symptoms with physical health problems is important because these may be treatable conditions for which survivors seek follow-up care and underscores the need for a multidisciplinary approach to survivor care.

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Yu, Chu-Ling, Emily S. Tonorezos, Chiung-Yu Huang, Brian C.-H. Chiu, Chun-Ju Chiang, Hui-Ju Ch'ang, Yen-Lin Liu, James S. Miser, Hung-Yi Chiou, and Yun Yen. "Second malignant neoplasms in a nationwide population-based cohort of childhood cancer survivors in Taiwan." Journal of Clinical Oncology 35, no. 15_suppl (May 20, 2017): 10569. http://dx.doi.org/10.1200/jco.2017.35.15_suppl.10569.

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10569 Background: Childhood cancer survivors have excess risk of second malignant neoplasms, but data are limited in Asian populations. We established a nationwide retrospective cohort of childhood cancer survivors in Taiwan to study the risk of second malignant neoplasms in the population. Methods: Children and adolescents diagnosed with cancer before age 21 years between 1990 and 2011 were identified from the Taiwan Cancer Registry, the national cancer registry in Taiwan. One-year survivors of childhood cancer were ascertained through data linkage with the national death registry. Survivors were followed up through December 2012. Standardized incidence ratios (SIRs), absolute excess risks (AERs), and cumulative incidence of second malignant neoplasms were calculated. Results: A total of 186 second malignant neoplasms occurred among 15,263 1-year survivors of childhood cancer after a mean follow-up time of 8.0 years (SIR = 5.4, 95% confidence interval [CI] = 4.6-6.2; AER = 12.4 per 10,000 person-years). The most common types of second malignant neoplasms were gastrointestinal cancers (n = 37), leukemia (n = 28), endocrine cancers (n = 18), and brain cancer (n = 17). Cancers in the liver (n = 11, including 9 hepatocellular carcinoma) and colorectum (n = 16) accounted for 73% of second gastrointestinal malignant neoplasms in this population. The cumulative incidence of second malignant neoplasms at 10 and 20 years from follow-up was 1.0% (95% CI = 0.8-1.2%) and 3.0% (95% CI = 2.3-3.6%), respectively. Conclusions: Childhood cancer survivors in Taiwan experience excess risk of second malignant neoplasms, in particular gastrointestinal cancers, compared with the general population.

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Moskowitz, Chaya S., Joanne F. Chou, Joseph P. Neglia, Ann H. Partridge, Rebecca M. Howell, Lisa R. Diller, Danielle Novetsky Friedman, et al. "Mortality After Breast Cancer Among Survivors of Childhood Cancer: A Report From the Childhood Cancer Survivor Study." Journal of Clinical Oncology 37, no. 24 (August 20, 2019): 2120–30. http://dx.doi.org/10.1200/jco.18.02219.

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PURPOSE Female survivors of childhood cancer have a high risk of subsequent breast cancer. We describe the ensuing risk for mortality and additional breast cancers. PATIENTS AND METHODS Female participants in the Childhood Cancer Survivor Study, a cohort of 5-year survivors of cancer diagnosed between 1970 and 1986 before age 21 years, and subsequently diagnosed with breast cancer (n = 274; median age at breast cancer diagnosis, 38 years; range, 20 to 58 years) were matched to a control group (n = 1,095) with de novo breast cancer. Hazard ratios (HRs) and 95% CIs were estimated from cause-specific proportional hazards models. RESULTS Ninety-two childhood cancer survivors died, 49 as a result of breast cancer. Overall survival after breast cancer was 73% by 10 years. Subsequent risk of death as a result of any cause was higher among childhood cancer survivors than among controls (HR, 2.2; 95% CI, 1.7 to 3.0) and remained elevated after adjusting for breast cancer treatment (HR, 2.4; 95% CI, 1.7 to 3.2). Although breast cancer–specific mortality was modestly elevated among childhood cancer survivors (HR, 1.3; 95% CI, 0.9 to 2.0), survivors were five times more likely to die as a result of other health-related causes, including other subsequent malignant neoplasms and cardiovascular or pulmonary disease (HR, 5.5; 95% CI, 3.4 to 9.0). The cumulative incidence of a second asynchronous breast cancer also was elevated significantly compared with controls ( P < .001). CONCLUSION Mortality after breast cancer was higher in childhood cancer survivors than in women with de novo breast cancer. This increased mortality reflects the burden of comorbidity and highlights the need for risk-reducing interventions.

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Bhatia, Smita, and Charles Sklar. "Second cancers in survivors of childhood cancer." Nature Reviews Cancer 2, no. 2 (February 2002): 124–32. http://dx.doi.org/10.1038/nrc722.

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Smith, Helin, and Bob Phillips. "Childhood Cancer." InnovAiT: Education and inspiration for general practice 5, no. 10 (September 14, 2012): 595–603. http://dx.doi.org/10.1093/innovait/ins133.

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Childhood cancers are uncommon, accounting for only 0.5% of all cancers in the UK. Approximately, 1500 children are diagnosed with cancer in the UK every year. Despite it being a rare occurrence, cancer still remains the largest cause of death in the 1–14 year age group, amongst whom it counts for 20% of all deaths. Although most adult cancers affect the lung, breast, bowel and prostate, the majority of childhood cancers are haematological and central nervous system (CNS) tumours. The primary care physician's role is vital across the disease trajectory, requiring them to recognize the signs and symptoms of childhood cancer, understand treatment, provide support to children and families, and finally consider the issues affecting survivors of childhood cancer.

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Ford, Jennifer S., Toana Kawashima, John Whitton, Wendy Leisenring, Caroline Laverdière, Marilyn Stovall, Lonnie Zeltzer, Leslie L. Robison, and Charles A. Sklar. "Psychosexual Functioning Among Adult Female Survivors of Childhood Cancer: A Report From the Childhood Cancer Survivor Study." Journal of Clinical Oncology 32, no. 28 (October 1, 2014): 3126–36. http://dx.doi.org/10.1200/jco.2013.54.1086.

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Purpose Childhood cancer survivors may be at risk for impaired psychosexual functioning as a direct result of their cancer or its treatments, psychosocial difficulties, and/or diminished quality of life. Patients and Methods Two thousand one hundred seventy-eight female adult survivors of childhood cancer and 408 female siblings from the Childhood Cancer Survivor Study (CCSS) completed a self-report questionnaire about their psychosexual functioning and quality of life. On average, participants were age 29 years (range, 18 to 51 years) at the time of the survey, had been diagnosed with cancer at a median age of 8.5 years (range, 0 to 20) and were most commonly diagnosed with leukemia (33.2%) and Hodgkin lymphoma (15.4%). Results Multivariable analyses suggested that after controlling for sociodemographic differences, survivors reported significantly lower sexual functioning (mean difference [MnD], −0.2; P = .01), lower sexual interest (MnD, −0.2; P < .01), lower sexual desire (MnD, −0.3; P < .01), lower sexual arousal (MnD, −0.3; P < .01), lower sexual satisfaction (MnD, −0.2; P = .01), and lower sexual activity (MnD, −0.1; P = .02) compared with siblings. Risk factors for poorer psychosexual functioning among survivors included older age at assessment, ovarian failure at a younger age, treatment with cranial radiation, and cancer diagnosis during adolescence. Conclusion Decreased sexual functioning among female survivors of childhood cancers seems to be unrelated to emotional factors and is likely to be an underaddressed issue. Several risk factors among survivors have been identified that assist in defining high-risk subgroups who may benefit from targeted screening and interventions.

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Nathan, P. C., K. K. Ness, M. M. Hudson, M. Mahoney, J. S. Ford, W. Landier, G. Armstrong, T. Henderson, L. L. Robison, and K. C. Oeffinger. "Cancer screening in adult survivors of childhood cancer: A report from the Childhood Cancer Survivor Study (CCSS)." Journal of Clinical Oncology 27, no. 18_suppl (June 20, 2009): CRA6501. http://dx.doi.org/10.1200/jco.2009.27.18_suppl.cra6501.

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CRA6501 Background: Childhood cancer survivors may develop a second malignant neoplasm (SMN) and require surveillance to detect new cancers. Methods: We surveyed survivors and siblings from the CCSS, a cohort study of patients who have survived ≥5 years after a diagnosis of childhood cancer from 1970–86. We assessed compliance with the American Cancer Society's (ACS) guidelines for surveillance mammography, colonoscopy and PAP smears, and compared them to a matched population comparison group drawn from the 2003 National Health Interview Survey. Further, we examined compliance with the Children's Oncology Group (COG) guidelines for more frequent colonoscopy, mammography and skin exams in survivors at high risk for cancers of the colon (≥30 Gy pelvic, abdominal or spinal radiation), breast (≥ 20 Gy breast radiation in females) or skin (any radiation). Proportions screened were compared between groups with adjusted generalized estimating equations or log-binomial regression models. Results: There were 8318 survivors (50.6% male, mean age at interview 31.2 ± 7.3 years), 2661 siblings and 8318 population controls. 141/829 (17.6%), 592/855 (70.4%) and 3362/3690 (92.6%) eligible survivors reported a colonoscopy, mammogram, or PAP smear per ACS guidelines. Survivors were less likely than siblings (odds ratio [OR] 0.30; 95% confidence interval [CI] 0.18–0.49) and population controls (OR 0.63; CI 0.50–0.80) to have a colonoscopy, and less likely than siblings to have a PAP smear (risk ratio [RR] 0.98; CI 0.97–0.99). However, they were more likely than siblings (RR 1.14; CI 1.03–1.27) and population controls (RR 1.05; CI 1.01–1.10) to have a mammogram. Among survivors at increased risk for a SMN, only 92/809 (11.4%) reported a colonoscopy within the COG recommended 5-year period, 164/537 (30.5%) reported a mammogram within a 1-year period and 1288/4833 (26.7%) reported a skin exam. Care at a cancer center was associated with mammography (RR 1.91; 95% CI 1.02–1.27) and skin exam (RR 1.55; 95% CI 1.22–196) in high-risk patients. Conclusions: Childhood cancer survivors are not screened adequately for SMNs. Surveillance is very poor amongst those at highest risk for colon, breast, or skin cancer. Survivors and their physicians need education about the importance of surveillance. No significant financial relationships to disclose.

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Aung, LeLe, Yiong Huak Chan, Eng Juh Yeoh, Poh Lin Poh Lin, and Thuan Chong Quah. "A Report from the Singapore Childhood Cancer Survivor Study (SG-CCSS): A Multi-institutional Collaborative Study on Long-term Survivors of Childhood Cancer, Initial Analysis Reporting for the SG-CCSS." Annals of the Academy of Medicine, Singapore 38, no. 8 (August 15, 2009): 684–89. http://dx.doi.org/10.47102/annals-acadmedsg.v38n8p684.

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Introduction: Worldwide, the survival rates among childhood cancer patients are increasing. As such, assessing the risk of late effects and complications are increasingly becoming more important. The degree of risk of late effects may be influenced by various treatment-related factors. Materials and Methods: The Singapore Childhood Cancer Survivor Study (SG- CCSS) consists of all individuals who survived at least 2 or more years after treatment for cancer diagnosed during childhood or adolescence. Phase I of SG-CCSS is the identification of all eligible patients between 1981 and 2005. Results: There were a total of 1440 patients registered in the Singapore Childhood Cancer Registry. Among these, 704 (48.9%) patients were from the KK Women’s and Children’s Hospital (KKH) and 626 (43.5%) were from the National University Hospital (NUH). Of all the registered patients, the most common cancer in childhood was leukaemia [42.6% (n = 613)] and the second most common was brain tumour [14.9% (n = 215)]. A total of 1043 (72.4%) patients were surviving, of whom 839 (80.4%) were long-term survivors. Haematological malignancies were found in 492 (58.6%) survivors whilst 347 (41.4%) were diagnosed with various solid tumours. Among leukaemic patients (n = 613), 65.6% (n = 402) were long-term survivors. Acute lymphoblastic leukaemia (ALL) (n = 484) had the highest percentage of [80.9% (n = 392)] of surviving patients, of whom 73.4% were long term-survivors. For brain tumour (n = 215), there were 95 (44.2%) long-term survivors. Conclusion: Preliminary analysis revealed that 58.3% of patients were long-term survivors. Our hope is to tailor all future therapy for childhood cancers, optimising cure rates whilst minimising long-term side-effects. Key words: Late effects

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Hudson, Melissa M., Daniel A. Mulrooney, Daniel C. Bowers, Charles A. Sklar, Daniel M. Green, Sarah S. Donaldson, Kevin C. Oeffinger, Joseph P. Neglia, Anna T. Meadows, and Leslie L. Robison. "High-Risk Populations Identified in Childhood Cancer Survivor Study Investigations: Implications for Risk-Based Surveillance." Journal of Clinical Oncology 27, no. 14 (May 10, 2009): 2405–14. http://dx.doi.org/10.1200/jco.2008.21.1516.

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Childhood cancer survivors often experience complications related to cancer and its treatment that may adversely affect quality of life and increase the risk of premature death. The purpose of this manuscript is to review how data derived from Childhood Cancer Survivor Study (CCSS) investigations have facilitated identification of childhood cancer survivor populations at high risk for specific organ toxicity and secondary carcinogenesis and how this has informed clinical screening practices. Articles previously published that used the resource of the CCSS to identify risk factors for specific organ toxicity and subsequent cancers were reviewed and results summarized. CCSS investigations have characterized specific groups to be at highest risk of morbidity related to endocrine and reproductive dysfunction, pulmonary toxicity, cerebrovascular injury, neurologic and neurosensory sequelae, and subsequent neoplasms. Factors influencing risk for specific outcomes related to the individual survivor (eg, sex, race/ethnicity, age at diagnosis, attained age), sociodemographic status (eg, education, household income, health insurance) and cancer history (eg, diagnosis, treatment, time from diagnosis) have been consistently identified. These CCSS investigations that clarify risk for treatment complications related to specific treatment modalities, cumulative dose exposures, and sociodemographic factors identify profiles of survivors at high risk for cancer-related morbidity who deserve heightened surveillance to optimize outcomes after treatment for childhood cancer.

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Chemaitilly, Wassim, Ann C. Mertens, Pauline Mitby, John Whitton, Marilyn Stovall, Yutaka Yasui, Leslie L. Robison, and Charles A. Sklar. "Acute Ovarian Failure in the Childhood Cancer Survivor Study." Journal of Clinical Endocrinology & Metabolism 91, no. 5 (May 1, 2006): 1723–28. http://dx.doi.org/10.1210/jc.2006-0020.

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Context: Defined as the loss of ovarian function within 5 yr of diagnosis, acute ovarian failure (AOF) is known to develop in a subset of survivors of pediatric and adolescent cancers. Its precise incidence is unknown, and data concerning its risk factors are limited. Objective: Our objective was to determine the incidence of and patient/treatment factors associated with AOF in a large cohort of pediatric cancer survivors. Design and Setting: We conducted a retrospective cohort, multicenter study. Patients: Female participants from the Childhood Cancer Survivor Study who were greater than 18 yr of age were considered for inclusion. We excluded survivors who received cranial irradiation at doses of more than 3000 cGy, those with hypothalamic/pituitary tumors, and survivors who underwent bilateral oophorectomy. Survivors who reported never menstruating or who had ceased having menses within 5 yr after their cancer diagnosis were considered to have AOF. Main Outcome: We assessed incidence and risk factors for AOF. Results: Of a total of 3390 eligible survivors, 215 cases (6.3%) developed AOF. Survivors with AOF were older at diagnosis and more likely to have been diagnosed with Hodgkin’s lymphoma or to have received abdominal or pelvic radiotherapy than survivors without AOF. Among survivors with AOF, 116 (54%) had received at least 1000-cGy ovarian irradiation. In a multivariable logistic regression model, increasing doses of ovarian irradiation, exposure to procarbazine, and exposure to cyclophosphamide at ages 13–20 yr were independent risk factors for AOF. Conclusions: AOF develops in a small subset of survivors, especially those treated with at least 1000-cGy ovarian radiation. These results will facilitate patient counseling and selection of candidates for newer fertility preservation techniques.

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Дисертації з теми "Survivors of childhood cancers"

Vangile, Kirsten M. "Childhood Cancer Survivors: Patient Characteristics." Digital Archive @ GSU, 2008. http://digitalarchive.gsu.edu/iph_theses/51.

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Survivors of childhood cancer are a relatively new phenomenon in the medical world. The introduction of treatment protocols in the 1970s started a trend in curing children of cancer that historically had been a death sentence. Under these treatment protocols children were given different treatment regimens based on past research that helped remove cancerous cells from their bodies, but were later found to be the cause of treatment related morbidities years into the future; for most survivors roughly ten to 20 years post treatment. These morbidities, commonly called late-effects, are the prime reason that survivors of childhood cancer need to participate in survivorship care. Survivors of childhood cancer are particularly vulnerable to late-effects because the majority of them receive their treatment at a time when their bodies are still growing and developing. Survivorship care services vary by site, but all maintain the common goals of providing long-term follow up for the survivor and education about the ways in which treatments may affect a survivors’ health as they age. Similar to many other facets of healthcare and medicine, there are many populations who do not participate in survivorship care. The purpose of this research is to identify possible barriers to care, assess the level of impact these barriers have upon the survivor’s potential for participation and provide suggestions as to how these barriers can be mitigated. Additionally, this research highlights areas that need further research and analysis.

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Janson, Christopher M. "Marriage and Divorce in Survivors of Childhood Cancer: A Report from the Childhood Cancer Survivor Study." Yale University, 2008. http://ymtdl.med.yale.edu/theses/available/etd-08092007-145913/.

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In this report from the Childhood Cancer Survivor Study (CCSS), we described marriage and divorce rates in survivors of childhood cancer, as compared to a sibling control group and the general U.S. population. We also sought to identify patient and treatment characteristics that were associated with survivor marital status. This study included 8,930 five-year survivors of childhood malignancy and 2,855 sibling controls participating in the CCSS. Data on marital status, sociodemographic factors, and current health status were obtained from questionnaires; detailed disease and treatment histories were available from medical records. Marital status of the U.S. population was obtained from the 2002 Current Population Survey of the U.S. Census. We found that survivors were more likely to have never married than both sibling (odds ratio [OR] = 1.79; 95 % CI = 1.65-1.94; p < 0.0001) and population controls (OR = 2.29; 95 % CI = 2.19-2.38; p < 0.0001), with persistence of trends across age and gender strata. Once married, survivors divorced at rates equivalent to controls. In adjusted analysis, we found that several survivor characteristics predicted never-married status, including treatment involving cranial radiation (OR = 2.41; p < 0.0001), CNS tumor diagnosis (OR = 2.05; p < 0.0001), history of growth hormone deficiency (OR = 2.02; p < 0.0001), and unemployment secondary to disability (OR = 1.78; p = 0.0001). Survivor characteristics predictive of divorce included unemployment (OR = 1.91; p < 0.0001, for unemployed or disabled), lower educational achievement (OR = 1.74; p < 0.0001, for non-college graduates), and psychological distress (OR = 1.60; p < 0.0001). This study confirms prior reports of lower marriage rates in survivors of childhood cancer, providing further evidence that this population struggles with psychosocial adjustment to adult life.

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Thomson, Angela B. "Male fertility in survivors of childhood cancer." Thesis, University of Edinburgh, 2003. http://hdl.handle.net/1842/27532.

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The successful treatment of childhood cancer with chemotherapy and radiotherapy may be associated with testicular damage resulting in impaired spermatogenesis and temporary or permanent infertility in adulthood. In this study testicular function and semen quality was investigated in 33 survivors of childhood cancer. Treatment of childhood cancer was associated with a significant risk of impaired spermatogenesis, with 30.3% of this population being azoospermic and 18.2% being oligozoospermic. Moreover, in those men who do have surviving spermatogenesis after treatment, it is commonly compromised, with reductions being observed in ejaculate volume, sperm concentration, sperm motility and the proportion of morphologically normal sperm. Only 33.3% of this group of 33 male childhood cancer survivors had completely normal semen quality by conventional criteria. However, the sperm produced do not appear to carry a greater burden of damaged DNA compared with the healthy population, suggesting that assisted conception treatment is a safe option for these men. Detection of gonadal damage in the prepubertal male is hampered by lack of a sensitive marker. The role of inhibin B as a marker of early gonadotoxic effects of chemotherapy in prepubertal children treated for cancer was investigated. In prepubertal boys, chemotherapy had little immediate effect on Sertoli cell production of inhibin B during and immediately after treatment stopped, although one boy showed a delayed deleterious effect. Inhibin B changed earlier and appeared to be a more sensitive marker of gonadal damage than FSH or LH. Prospective studies are underway combining inhibin B with FSH, LH and sex hormone measurements, to assess the impact of cancer therapy on gonadal function in children, particularly as they approach and progress through puberty. For prepubertal boys fertility preservation through semen cryopreservation is not an option and consequently, attention is focusing on the development of techniques that might preserve or restore fertility potential in boys being subjected to gonadotoxic cancer therapy. In rats, it has been shown that some germ cells survive cytotoxic therapy and that the resulting azoospermia is a consequence of the inability of those spermatogonia that are present to proliferate and differentiate. Suppression of the hypothalamic-pituitary-gonadal (H-P-G) axis facilitates recovery of spermatogenesis following such cytotoxic treatment. Investigation of whether suppression of the H-PG axis in men rendered azoospermic by treatment for childhood cancer might restore spermatogenesis was undertaken, using both semen analysis and testicular biopsy as end points. In men treated with sterilising radiotherapy and chemotherapy for childhood cancer, effective gonadotrophin suppression with medroxyprogesterone acetate for at least 3 months did not result in restoration of spermatogenesis. The absence of histological evidence of spermatogonial stem cells in testicular biopsies from these men before and after suppression suggests complete ablation of the germinal epithelium and irreversible infertility. Understanding the vulnerability of the prepubertal human testis to cytotoxic damage is compounded by the dearth of data describing normal testicular development in the prepubertal human. Based on immunohistochemical studies in marmosets, a primate that exhibits a similar developmental profile to the human male, it has been shown that significant testicular development occurs during childhood long before the clinical onset of puberty. If we can establish that cell activity does occur in the 'quiescent' testis in boys and is comparable to changes shown in the marmoset, it will validate use of the marmoset as a model for the human in this instance and give encouragement to the possibility of using this primate model to develop a method of protecting spermatogenesis in boys undergoing cancer therapy prior to puberty. Preliminary studies to investigate the development of the prepubertal human testis confirmed testicular cell activity in the foetal and neonatal periods and infancy comparable to that shown in the marmoset. However, to date development during mid childhood and early puberty has proved to be somewhat discordant with the marmoset studies. It is too premature to definitively conclude that marmoset and human testicular development are dissimilar, as a number of explanations have been proffered to explain the discrepancies, including suboptimal tissue fixation and antigen preservation in the human tissues.

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Absolom, Kate L. "Follow-up for survivors of childhood cancer." Thesis, University of Sheffield, 2005. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.425627.

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Russell, Claire C. "LONGITUDINAL PREDICTORS OF QUALITY OF LIFE IN ADOLESCENT SURVIVORS OF CHILDHOOD CANCER: A REPORT FROM THE CHILDHOOD CANCER SURVIVOR STUDY." VCU Scholars Compass, 2013. http://scholarscompass.vcu.edu/etd/3160.

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Objective: The impact of childhood cancer on future quality of life (QoL) in survivors is unclear. Current studies focus on comparing outcomes to healthy peers and identifying related treatment and demographic variables, but a shift in our approach is necessary. This study is guided by the Wilson and Cleary Model (WMC) and seeks to identify longitudinal predictors of QoL in adolescent survivors of cancer that explain variance in QoL beyond the impact of treatment and demographic variables. Methods: The Childhood Cancer Survivor Study (CCSS) is a multi-institutional longitudinal study following a cohort of childhood cancer survivors. This study focuses on the CCSS cohort (N = 305) who completed the baseline survey in 1994 and the Teen survey in 2001. The baseline survey assessed parent-report of child’s psychological and physical symptoms, functional status, and health perceptions. The Teen survey utilized the Child Health and Illness Profile – Adolescent Edition (CHIP-AE), a self-report measure assessing QoL in six domains: achievement, resilience, satisfaction, discomfort, disorders, and risk. The primary hypothesis was that psychological and physical symptoms, functional status impairment, and health perceptions as rated by parents at baseline would predict variance in quality of life as rated by adolescents at follow-up after adjusting for demographic and treatment-related variables. Six separate hierarchical regressions were analyzed for each of the QoL domains. Results: The main hypothesis was supported. For each QoL outcome, a significant amount of variance was predicted: achievement, F (6, 259) = 8.90, p < .001, adjusted R2 = .152, resilience, F (12, 209) = 3.47, p < .001, adjusted R2 = .118, satisfaction, F (6, 265) = 8.73, p < .001, adjusted R2 = .146, discomfort, F (7, 273) = 6.75, p < .001, adjusted R2 = .126, disorders, F (9, 212) = 6.47, p < .0001, adjusted R2 = .182, and risk, F (7, 238) = 4.81, p < .001, adjusted R2 = .098. Furthermore, for all outcomes, psychological and physical symptoms, functional status impairment, and health perceptions predicted variance above and beyond the impact of demographic and treatment variables. These factors accounted for an additional 9.5% of the variance in the achievement domain, 6.2% for resilience, 10.8% for satisfaction, 6.5% for discomfort, 12.4% for disorders, and 6.1% for risk. Conclusions: Results suggest that psychological and physical symptoms, functional status and health perceptions should be assessed and targeted in interventions for childhood cancer survivors to promote future positive QoL. Future studies need to continue identifying factors related to positive long-term functioning in diverse samples of childhood cancer survivors.

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McMillan, Amy. "Educational late effects among survivors of childhood cancer." Thesis, University of British Columbia, 2007. http://hdl.handle.net/2429/31601.

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Increased survival rates of childhood cancer have meant a growing population of survivors within the education system. Although research suggests that survivors face educational difficulties, methodological shortcomings and lack of consensus have contributed to difficulties interpreting this literature. Moreover, there exists a paucity of literature objectively measuring survivors' educational outcomes, particularly achievement. In this population-based research, 782 survivors of childhood cancer from the BC cancer registry, and BC school system from 1995-2004, were age and gender-matched with a randomly selected control group of 8386 BC schoolchildren. Objective educational measures including Foundation Skills Assessments (FSAs), Provincial examinations, and special education designations from the BC Ministry of Education were compared between the survivor and control cohorts; potential disease-related risks among survivors were assessed. Survivors were significantly more likely than controls to have special education or physical disability designations and performed significantly more poorly on several FSAs. Notably, once survivors of central nervous system (CNS) tumours and leukemia were excluded from the analysis, there were no significant achievement differences. Survivors younger at diagnosis (<2 years) had higher educational achievement, despite having more hearing and visual impairments than survivors older at diagnosis ([Greater Than or Equal to] 5 years). Childhood cancer survivors appear at increased risk for special education utilization. In particular, survivors of leukemia and CNS tumours may be at increased risk for poor educational achievement and special education designations. It is important that potential adverse educational outcomes and associated risk factors be identified such that surveillance and appropriate interventions be provided to ensure survivors a successful educational experience.
Education, Faculty of
Educational and Counselling Psychology, and Special Education (ECPS), Department of
Graduate

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Behera, Malabika. "Long term endocrine sequelae of childhood cancer survivors." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2014. http://hdl.handle.net/10722/206611.

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Background: Newer multimodality therapeutic interventions have resulted in dramatic survival rates in childhood cancers. However diverse treatment related morbidities affect the long term survivors. An Endocrine complication comprises 20-40% of these morbidities and affects the hypothalamic pituitary axis, growth, pubertal progression, fertility, bone health and glucose homeostasis. Objectives: The aim of our study was to enumerate and evaluate the frequency of endocrine complications arising as a late effect of treatment in childhood cancer survivors. Risk factors likely to be associated with these complications were also evaluated. Methodology: Retrospective analysis of medical records from the Long Term Endocrine Follow up clinic in the Department of Paediatrics and Adolescent Medicine of Queen Mary Hospital was done. Patients with a primary diagnosis of Cancer and Langerhans cell histiocytosis with endocrine sequelae arising from various treatment modalities who have survived 5 years after diagnosis were included in the study. Those who had endocrine complications arising from various treatment modalities for Thalassemia’s, Immunodeficiency’s were excluded from the study Results: 135 cases were included in the study and 27 were excluded. Leukemia and Brain tumor survivors were the majority accounting for 40% and 26.67% respectively. ALL formed majority of leukemia survivors, Medulloblastoma survivors accounted for 50% of brain tumor survivors. Most common endocrine problem was Hypogonadism in 51.1% of cases, followed by growth disturbances in 40%, Thyroid dysfunction in 23% and Hyperlipidemias in 18.5%. Pubertal problems, Central Diabetes Insipidus, Adrenal insufficiency, Obesity, Altered glucose homeostasis were rest of the problems in small frequencies. PHGN (Primary Hypogonadism) was present in 91.3% and mostly in prepubertal males. PHGN was statistically associated with Leukemia survivors with OR-2.06 (1.02- 4.15), p value 0.04. The risk factors associated were exposure to alkylating agents, radiotherapy, TBI prior to transplant. SHGN (Secondary HGN) was statistically associated with Brain tumor survivor OR - 15.8 (1.7-140.5), p value 0.013. Cranial irradiation was the major risk for SHGN. PGV (Poor growth velocity) was the major growth problem.GHD (Growth Hormone Deficiency) had a highly significant association with Brain tumors (p value ˂ 0.0001), and significantly associated when all 3 modalities of treatment given together (p value 0.01). Risk factors for GHD were cranial radiotherapy, exposure to cyclophosphamide and TBI. PH (Primary Hypothyroidism) had highly significant association with craniospinal radiotherapy (p value ˂ 0.0001), and significantly associated with brain tumors. Similar results were observed in patients of CH (Central Hypothyroidism). Hyperlipidemias were present in 18% with no statistical correlation with the type of cancer. Brain tumor survivors had a significant association of GHD, PH, CH, SHGN and CDI. Leukemia survivors had significant association with GHD and PHGN. Conclusions: Endocrine problems are frequent manifestations of late effects of cancer related treatments. Early detection and intervention of these potentially treatable problems could be done through structured long term surveillance. Increasing awareness among health care professionals to anticipate problems in suspected patients and education of patients would optimize health care and quality of life.
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Paediatrics and Adolescent Medicine
Master
Master of Medical Sciences

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Reulen, Raoul. "Adverse health outcomes in survivors of childhood cancer." Thesis, University of Birmingham, 2009. http://etheses.bham.ac.uk//id/eprint/265/.

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This thesis concerns investigations into adverse health outcomes among survivors of childhood cancer using the British Childhood Cancer Survivor Study (BCCSS). The BCCSS is a large-scale population-based cohort of 17,981 survivors of childhood cancer who were diagnosed with childhood cancer (age 0-14 years) between 1940 and 1991, in Britain, and had survived for at least five years. The specific aims were to investigate, within the BCCSS cohort; (1) the psychometric properties of the SF-36 health-status questionnaire, (2) the self-reported health-status by using the SF-36, (3) the effect of therapeutic radiation on the offspring sex ratio, (4) the risks of adverse pregnancy outcomes, and (5) the risks of second primary breast cancer. This thesis demonstrates that the SF-36 questionnaire exhibits good validity and reliability when used in long-term survivors of childhood cancer. Survivors rate their physical and mental health similarly to those in the general population, apart from bone and central nervous system tumour survivors who rate their physical health below population norms. Therapeutic irradiation does not alter the sex ratio of offspring. Female survivors exposed to abdominal irradiation are at a three-fold risk of delivering premature and two-fold risk of producing low birth-weight offspring. Lastly, the risk of breast cancer among female survivors is two-fold that of the general population, but is not sustained into ages at which the risk of breast cancer in the general population becomes substantial.

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WIERMAA, JACQUELYN DAWN. "HEALTH BEHAVIORS IN ADULT SURVIVORS OF CHILDHOOD CANCER." University of Cincinnati / OhioLINK, 2002. http://rave.ohiolink.edu/etdc/view?acc_num=ucin1021032822.

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Kamonchaiwanich, Jinda. "Dental late effects in survivors of childhood cancer." Thesis, Faculty of Dentistry, 1994. http://hdl.handle.net/2123/4580.

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Книги з теми "Survivors of childhood cancers"

Schwartz, Cindy L., Wendy L. Hobbie, Louis S. Constine, and Kathleen S. Ruccione, eds. Survivors of Childhood and Adolescent Cancer. Cham: Springer International Publishing, 2015. http://dx.doi.org/10.1007/978-3-319-16435-9.

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Schwartz, Cindy L., Wendy L. Hobbie, Louis S. Constine, and Kathleen S. Ruccione, eds. Survivors of Childhood and Adolescent Cancer. Berlin, Heidelberg: Springer Berlin Heidelberg, 2005. http://dx.doi.org/10.1007/b137709.

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Müller, Christian. Childhood Cancer Survivors with Chronic Diseases. Cham: Springer International Publishing, 2023. http://dx.doi.org/10.1007/978-3-031-31797-2.

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L, Schwartz Cindy, ed. Survivors of childhood cancer: Assessment and management. St. Louis: Mosby, 1994.

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Keene, Nancy. Childhood cancer survivors: A practical guide to your future. Beijing: O'Reilly, 2000.

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L, Schwartz Cindy, ed. Survivors of childhood and adolescent cancer: A multidisciplinary approach. 2nd ed. Berlin: Springer, 2005.

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1959-, Hobbie Wendy, and Ruccione Kathy 1946-, eds. Childhood cancer survivors: A practical guide to your future. 2nd ed. Beijing: O'Reilly, 2007.

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1959-, Hobbie Wendy, and Ruccione Kathy 1946-, eds. Childhood cancer survivors: A practical guide to your future. 3rd ed. Beijing: O'Reilly, 2012.

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Hamish, Wallace, and Green Daniel M, eds. Late effects of childhood cancer. London: Arnold, 2003.

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Mucci, Grace A., and Lilibeth R. Torno, eds. Handbook of Long Term Care of The Childhood Cancer Survivor. Boston, MA: Springer US, 2015. http://dx.doi.org/10.1007/978-1-4899-7584-3.

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Частини книг з теми "Survivors of childhood cancers"

Smith, Stephanie M., Lauren Jimenez-Kurlander, Lindsay Schwartz, Tara O. Henderson, and Danielle Novetsky Friedman. "Adult Survivors of Childhood Cancers." In Essentials of Cancer Survivorship, 6–23. Boca Raton: CRC Press, 2021. http://dx.doi.org/10.1201/9781003055426-3.

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de Boer, Angela, Jos Verbeek, and Frank van Dijk. "Young Survivors of Childhood Cancer." In Work and Cancer Survivors, 163–88. New York, NY: Springer New York, 2008. http://dx.doi.org/10.1007/978-0-387-72041-8_8.

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Raghunathan, Nirupa Jaya, Larissa Nekhlyudov, and Linda S. Overholser. "Childhood and Adolescent Cancer Survivors." In Care of Adults with Chronic Childhood Conditions, 87–101. Cham: Springer International Publishing, 2016. http://dx.doi.org/10.1007/978-3-319-43827-6_6.

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Urquhart-Kelly, Tanya L., and Jerry K. Wales. "Transition of Childhood Cancer Survivors." In Advanced Practice in Endocrinology Nursing, 1123–32. Cham: Springer International Publishing, 2019. http://dx.doi.org/10.1007/978-3-319-99817-6_58.

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Valtis, Yannis K., Linda S. Overholser, and Larissa Nekhlyudov. "Childhood and Adolescent Cancer Survivors." In Care of Adults with Chronic Childhood Conditions, 331–54. Cham: Springer International Publishing, 2024. http://dx.doi.org/10.1007/978-3-031-54281-7_26.

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Müller, Christian. "Past of Childhood Cancer." In Childhood Cancer Survivors with Chronic Diseases, 3–7. Cham: Springer International Publishing, 2023. http://dx.doi.org/10.1007/978-3-031-31797-2_1.

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Müller, Christian. "Incidence of Global Childhood Cancer." In Childhood Cancer Survivors with Chronic Diseases, 9–14. Cham: Springer International Publishing, 2023. http://dx.doi.org/10.1007/978-3-031-31797-2_2.

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De Bruin, Marie L., Eline Van Dulmen-den Broeder, Marleen H. Van den Berg, and Cornelis B. Lambalk. "Fertility in Female Childhood Cancer Survivors." In Endocrinopathy after Childhood Cancer Treatment, 135–58. Basel: KARGER, 2009. http://dx.doi.org/10.1159/000207613.

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Skinner, Roderick, and Lars Hjorth. "Kidney Disease in Childhood Cancer Survivors." In Late Treatment Effects and Cancer Survivor Care in the Young, 17–26. Cham: Springer International Publishing, 2020. http://dx.doi.org/10.1007/978-3-030-49140-6_2.

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Yuen, Kevin C. J. "Endocrine Complications in Childhood Cancer Survivors." In Blood and Marrow Transplant Handbook, 323–35. Cham: Springer International Publishing, 2015. http://dx.doi.org/10.1007/978-3-319-13832-9_26.

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Тези доповідей конференцій з теми "Survivors of childhood cancers"

Kim, Mirae, Kyubum Hwang, Hayoung Oh, Min Ah Kim, Chaerim Park, Yehwi Park, and Chungyeon Lee. "MILD Bot: Multidisciplinary Childhood Cancer Survivor Question-Answering Bot." In Proceedings of the 2024 Conference on Empirical Methods in Natural Language Processing: Industry Track, 665–76. Stroudsburg, PA, USA: Association for Computational Linguistics, 2024. http://dx.doi.org/10.18653/v1/2024.emnlp-industry.49.

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Howell, Rebecca. "Radiation-Therapy Related Cardiac Disease in Childhood Cancer Survivors." In The Image Guided Cancer Therapy (IGCT) Seminars. University of Texas MD Anderson Cancer Center, 2022. https://doi.org/10.52519/00187.

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Kasteler, Rahel, Linda Kam, Grit Sommer, Marc Ansari, Johannes Rischewski, Claudia Kuehni, and Annette Weiss. "Monitoring of pulmonary health in Swiss childhood cancer survivors." In ERS International Congress 2017 abstracts. European Respiratory Society, 2017. http://dx.doi.org/10.1183/1393003.congress-2017.pa4155.

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Kasteler, Rahel, Fabiën Belle, Fabienne Gumy-Pause, Eva M. Tinner, and Claudia Kuehni. "Prevalence and reasons for smoking in adolescent Swiss childhood cancer survivors." In ERS International Congress 2017 abstracts. European Respiratory Society, 2017. http://dx.doi.org/10.1183/1393003.congress-2017.pa2995.

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Kim, Mirae, Kyubum Hwang, Hayoung Oh, Heejin Kim, and Min Ah Kim. "Can a Chatbot be Useful in Childhood Cancer Survivorship? Development of a Chatbot for Survivors of Childhood Cancer." In CIKM '23: The 32nd ACM International Conference on Information and Knowledge Management. New York, NY, USA: ACM, 2023. http://dx.doi.org/10.1145/3583780.3615234.

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Liu, Jason J., Lindsay M. Morton, Amy Berrington de González, Peter D. Inskip, and Rochelle E. Curtis. "Abstract 3725: Subsequent gastrointestinal cancer risks of childhood and early adulthood cancer survivors." In Proceedings: AACR 106th Annual Meeting 2015; April 18-22, 2015; Philadelphia, PA. American Association for Cancer Research, 2015. http://dx.doi.org/10.1158/1538-7445.am2015-3725.

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Fiorino, EK, J. Ginsberg, C. Carlson, and SB Goldfarb. "Restrictive Lung Disease in Survivors of Childhood Cancer: A Chest Wall Abnormality." In American Thoracic Society 2009 International Conference, May 15-20, 2009 • San Diego, California. American Thoracic Society, 2009. http://dx.doi.org/10.1164/ajrccm-conference.2009.179.1_meetingabstracts.a3678.

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Armstrong, Gregory T. "Abstract IA23: The overall health burden on aging survivors of childhood cancer." In Abstracts: AACR Special Conference: Advances in Pediatric Cancer Research: From Mechanisms and Models to Treatment and Survivorship; November 9-12, 2015; Fort Lauderdale, Florida. American Association for Cancer Research, 2016. http://dx.doi.org/10.1158/1538-7445.pedca15-ia23.

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Diller, Lisa R. "Abstract IA25: Prevention in survivors: Reducing the “cost” of surviving childhood cancer." In Abstracts: AACR Special Conference: Advances in Pediatric Cancer Research: From Mechanisms and Models to Treatment and Survivorship; November 9-12, 2015; Fort Lauderdale, Florida. American Association for Cancer Research, 2016. http://dx.doi.org/10.1158/1538-7445.pedca15-ia25.

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Edvardsen, Elisabeth, Mari Bratteteig, Norunn Iren Matthews, Thomas Halvorsen, Ellen Ruud, and Trine Stensrud. "Do childhood cancer survivors have reduced pulmonary function compared to healthy individuals?" In ERS International Congress 2023 abstracts. European Respiratory Society, 2023. http://dx.doi.org/10.1183/13993003.congress-2023.pa4454.

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Звіти організацій з теми "Survivors of childhood cancers"

Snyder, Claire, Christina T. Yuan, Renee F. Wilson, Katherine Smith, Youngjee Choi, Paul C. Nathan, Allen Zhang, and Karen A. Robinson. Models of Care That Include Primary Care for Adult Survivors of Childhood Cancer: A Realist Review. Agency for Healthcare Research and Quality (AHRQ), February 2022. http://dx.doi.org/10.23970/ahrqepcrealistmodelsofcare.

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Objectives. We had two aims: (1) identify and analyze models of survivorship care for adult survivors of childhood cancer that include primary care, and (2) identify available tools, training, and other resources for adult survivors of childhood cancer. Methods. For each aim, we used realist synthesis to provide insights on how and for whom, in what contexts, and via what mechanisms the models of care and resources we identified can be effective for adult survivors of childhood cancer. We developed an initial program theory through searches of the literature and discussions with Stakeholders. We then identified and summarized quantitative evidence that supported or refuted the theory and developed specific hypotheses about how contexts and mechanisms may interact to produce outcomes (i.e., “CMO” hypotheses). The final program theory and CMO hypotheses were presented to Stakeholders for feedback. Results. Our final refined theory describes how, within the overall environment, survivor and provider characteristics and facilitators/barriers interact to produce intermediate and final outcomes. We focus on the role of models of care and resources (e.g., care plans) in these interactions. The program theory variables seen most consistently in the literature include oncology care versus primary care, survivor and provider knowledge (i.e., survivor risks and needs), provider comfort treating childhood cancer survivors, communication and coordination between and among providers and survivors, and delivery/receipt of prevention and surveillance of late effects of original cancer treatment. In turn, these variables played the most prominent role in the seven CMO hypotheses (4 focused on survivors and 3 focused on providers) regarding what works for whom and in what circumstances. Conclusions. To enable models of care that include primary care for adult survivors of childhood cancer, there needs to be communication of knowledge to both survivors and primary care providers. Our program theory provides guidance on the ways this knowledge could be shared, including the role of resources in doing so, and our CMO hypotheses suggest how the relationships illustrated in our theory could be associated with survivors living longer and feeling better through high-value care.

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Hendricks, Sam. Video: Better care for childhood cancer survivors. Monash University, February 2024. http://dx.doi.org/10.54377/696b-2665.

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Mobley, Erin M., Diana J. Moke, Joel Milam, Carol Y. Ochoa, Julia Stal, Nosa Osazuwa, Maria Bolshakova, et al. Disparities and Barriers to Pediatric Cancer Survivorship Care. Agency for Healthcare Research and Quality (AHRQ), March 2021. http://dx.doi.org/10.23970/ahrqepctb39.

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Objectives. Survival rates for pediatric cancer have dramatically increased since the 1970s, and the population of childhood cancer survivors (CCS) exceeds 500,000 in the United States. Cancer during childhood and related treatments lead to long-term health problems, many of which are poorly understood. These problems can be amplified by suboptimal survivorship care. This report provides an overview of the existing evidence and forthcoming research relevant to disparities and barriers for pediatric cancer survivorship care, outlines pending questions, and offers guidance for future research. Data sources. This Technical Brief reviews published peer-reviewed literature, grey literature, and Key Informant interviews to answer five Guiding Questions regarding disparities in the care of pediatric survivors, barriers to cancer survivorship care, proposed strategies, evaluated interventions, and future directions. Review methods. We searched research databases, research registries, and published reviews for ongoing and published studies in CCS to October 2020. We used the authors’ definition of CCS; where not specified, CCS included those diagnosed with any cancer prior to age 21. The grey literature search included relevant professional and nonprofit organizational websites and guideline clearinghouses. Key Informants provided content expertise regarding published and ongoing research, and recommended approaches to fill identified gaps. Results. In total, 110 studies met inclusion criteria. We identified 26 studies that assessed disparities in survivorship care for CCS. Key Informants discussed subgroups of CCS by race or ethnicity, sex, socioeconomic status, and insurance coverage that may experience disparities in survivorship care, and these were supported in the published literature. Key Informants indicated that major barriers to care are providers (e.g., insufficient knowledge), the health system (e.g., availability of services), and payers (e.g., network adequacy); we identified 47 studies that assessed a large range of barriers to survivorship care. Sixteen organizations have outlined strategies to address pediatric survivorship care. Our searches identified only 27 published studies that evaluated interventions to alleviate disparities and reduce barriers to care. These predominantly assessed approaches that targeted patients. We found only eight ongoing studies that evaluated strategies to address disparities and barriers. Conclusions. While research has addressed disparities and barriers to survivorship care for childhood cancer survivors, evidence-based interventions to address these disparities and barriers to care are sparse. Additional research is also needed to examine less frequently studied disparities and barriers and to evaluate ameliorative strategies in order to improve the survivorship care for CCS.

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Wernli, Karen, Susan Brandzel, Diana Buist, Mary Bush, Wendy DeMartini, Laura Ichikawa, Cameron Haas, et al. Is Breast MRI Better at Finding Second Breast Cancers than Mammograms Alone for Breast Cancer Survivors? Patient-Centered Outcomes Research Institute (PCORI), June 2019. http://dx.doi.org/10.25302/5.2019.ce.13046656.

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Bancalari, Antonella, Samuel Berlinski, Giancarlo Buitrago, María Fernanda García, Dolores de la Mata, and Marcos Vera-Hernández. Health Inequalities in Latin American and the Caribbean: Child, Adolescent, Reproductive, Metabolic Syndrome and Mental Health. Inter-American Development Bank, October 2023. http://dx.doi.org/10.18235/0005208.

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Health constitutes a fundamental aspect of our well-being. It is also a key factor in determining our contribution to market and non-market output. Health inequality refers to the unequal realization of health outcomes between different groups in the population. Systematic disparities in health outcomes and in access to health resources not only undermine basic principles of fairness and social justice but also contributes towards perpetuating poverty and disadvantage. In this chapter, we start by presenting evidence on how the burden of disease in Latin America and the Caribbean (LAC) has changed during the last 30 years. Consistent with the fall in fertility and population aging, the region has shifted from a burden of disease dominated by maternal, neonatal, and communicable disease in the 1990s to one dominated by cardiovascular disease, cancers, diabetes, and increasingly by mental health disorders. The poorest in the region are burdened by worst access to maternal care and higher levels of infant mortality and stunting. Despite being knowledgeable about contraceptive methods, young women in Latin America and the Caribbean have very high levels of teenage pregnancy with a steep socio-economic gradient. Noncommunicable diseases also affect the poor disproportionately in many countries. Finally, mental health is a growing source of lost days of healthy living among women and the poor. Overall, our results highlight that despite the epidemiological transition which is underway, socio-economic health disparities in the LAC region are still more important on early childhood and teenagerhood than in adulthood, at least as it pertains to the outcomes analyzed in this chapter. At the same time, we show that while socio-economic inequalities in child health are smaller in the richest countries, the contrary happens with inequalities in some adult outcomes.

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