What is included in the COG guidelines for cancer survivorship in children and young adults?

Updated: Feb 28, 2018
  • Author: Winston W Tan, MD, FACP; more...
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Answer

Children and young adults who survive cancer require plans that take into account their long life expectancy and provide extended follow-up to facilitate early detection and treatment of adverse effects, as well as of such secondary conditions as cardiac disease and cancers that can develop as a consequence of their cancer treatments. There are also psychosocial and financial effects of care that can have long-term consequences.

In 2013, the Children’s Oncology Group (COG) released guidelines focused on the lifetime screening needs for complications or adverse effects of therapy for cancer in children, adolescents, and young adults. The guidelines recommendations begin to apply 2 years after the completion of treatment and are not intended as guidance for follow-up of the primary disease. [14]

The COG anticipates that adoption of these guidelines might reduce the impact of late complications on this at-risk population by promoting healthy lifestyle choices and providing ongoing monitoring of health status. However, the COG acknowledges that the resulting enhanced awareness of possible complications could increase patient anxiety; the COG also recognizes the potential for false-positive screening evaluations, which could lead to unnecessary further workup. Finally, costs of long-term follow-up care may be prohibitive for some patients, particularly those whose insurance does not cover the recommended screening evaluations.

Preventive screening recommendations for adult-onset cancers are organized by organ, population risk factors, and highest risk factors for populations considered at significantly increased risk for each specific malignancy. The guidelines utilize the American Cancer Society screening recommendations for those individuals whose risk is equivalent to the standard risk of a person who has not had cancer. Recommendations are provided for those groups whose risk is determined to be significantly higher than that of the standard risk group.


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