Childhood cancer survivors: cardiac disease & social outcomes

The thesis is divided in two parts; Cardiac health problems and healthcare consumption & social outcomes in CCS. The general aims of part 1 creates optimal conditions for the evaluation of cardiac events in 5-year childhood cancer survivors, evaluation of the long term risk of cardiac events, and to uncover the associated risk factors. To create optimal conditions for the evaluation, we first developed a new valid and consistent method for assessing the severity of cardiac events. For proper risk assessment we need to calculate the cumulative dose of anthracyclines, however there is uncertainty about whether the cardiotoxic effects of the different types of anthracyclines are comparable. We therefore assessed the ratio of cardiotoxicity of doxorubicin versus daunorubicin. Furthermore we evaluated the long term risk of cardiac events, and associated risk factors in a nationwide Dutch cohort of childhood cancer survivors and we describe the methodology of a large European project, the study on cardiac health problems within PanCareSurFup.
Finally the general aims of part 2 are to evaluate healthcare consumption and social outcomes among 5-year childhood cancer survivors. We evaluated the hospitalization related health problems in survivors, by comparing them the general population. We also assessed risk factors for those health problems. Furthermore we compared survivors with the general population with respect to social outcomes. We evaluated if the survivors marry, work and live independently as much as their peers.