Guidelines for Complications of Cancer Treatment Vol VIII Part B

nonirradiated group did not differ from the population norm(standardized mortality ratio, 1.75; 95 percent confidenceinterval, 0.34 to 5.00). The rates of health insurance coverage,marriage, and employment in the nonirradiated group weresimilar to the age- and sex-adjusted national averages. Despitehaving health insurance rates similar to those in the generalpopulation, men and women in the irradiated group had higherthan-averageunemployment rates (15.1 percent vs. 5.4 percentand 35.4 percent vs. 5.2 percent, respectively), and women inthe irradiated group were less likely to be married (35.2 percentvs. 48.8 percent). CONCLUSIONS: Children with acutelymphoblastic leukemia who did not receive radiation therapyand who have attained 10 or more years of event-free survivalcan expect a normal long-term survival. Irradiation isassociated with the development of second neoplasms, a slightexcess in mortality, and an increased unemployment rate.Copyright 2003 Massachusetts Medical Society.2) Health status of adult long-term survivors ofchildhood cancer: a report from the ChildhoodCancer Survivor Study.Hudson MM, Mertens AC, Yasui Y, et al Jama. 2003;290:1583-92CONTEXT: Adult survivors of childhood cancer are at riskfor medical and psychosocial sequelae that may adverselyaffect their health status. OBJECTIVES: To compare the healthstatus of adult survivors of childhood cancer and siblings andto identify factors associated with adverse outcomes. DESIGN,SETTING, AND PARTICIPANTS: Health status was assessedin 9535 adult participants of the Childhood Cancer SurvivorStudy, a cohort of long-term survivors of childhood cancerwho were diagnosed between 1970 and 1986. A randomlyselected cohort of the survivors’ siblings (n = 2916) served asa comparison group. MAIN OUTCOME MEASURES: Six415