[Long-term follow-up program and transition medicine for childhood cancer survivors]

Because of recent advances in cancer treatments, about 70% of childhood cancer patients can be cured and reach adulthood. Childhood cancer survivors(CCS)are estimated to account for one out of 1,000 adults currently in their 20s. In the continuing care of CCS, two aspects of long-term follow-up(LTFU)are necessary different from that of adulthood cancer survivors. As CCS receive cancer treatment, including chemotherapy and radiotherapy, during their growth phase, one aspect of LTFU is monitoring for late side effects on their physiological and psychosocial growth. The other aspect is transition medicine to encourage adolescent and young adult(AYA)-CCS into adult-oriented medicine to receive age-appropriate clinical care. Because there are differences between child-oriented medicine and adult-oriented medicine, AYA-CCS often refuse to visit adult-oriented clinics or avoid follow-ups. Therefore, the establishment of a comprehensive LTFU system is necessary, and transition medicine began being introduced in the 1990s. In Japan, the importance of these aspects has just begun to be recognized and the system is still not fully established. In this paper, we discuss these LTFU topics together with current situations in Japan.