ABSTRACT
Approximately one in every 350 individuals living in the USA develops cancer before the age of 20 years. With current risk-based multimodality therapeutic approaches, more than 70 per cent of these children can be expected to be long-term survivors, with the 5-year survival rates ranging from more than 90 per cent to less than 50 per cent, depending on the specific diagnosis.1 As a result of this improvement in survival over the last three decades, increasing attention is now being focused on the growing population of individuals who have survived several years from their primary treatment. Sixty to seventy per cent of young adult survivors of childhood cancer are reported to develop at least one health-related complication as a result of their cancer or therapy. These complications include endocrine dysfunction, cardiopulmonary compromise, neurocognitive dysfunction and second primary cancers.2 A second primary cancer is defined as a histologically distinct second neoplasm that develops after the first neoplasm.
