Since the late 1960s, the survival rate in children and adolescents diagnosed with cancer has steadily improved, with a corresponding decline in the cancer-specific death rate. Although the improvements in survival are encouraging, they have come at the cost of acute, chronic, and late adverse effects precipitated by the toxicities associated with the individual or combined use of different types of treatment (e.g., surgery, radiation, chemotherapy). In some cases, the impairments resulting from cancer and its treatment are severe enough to qualify a child for U.S. Social Security Administration disability benefits. At the request of Social Security Administration, Childhood Cancer and Functional Impacts Across the Care Continuum provides current information and findings and conclusions regarding the diagnosis, treatment, and prognosis of selected childhood cancers, including different types of malignant solid tumors, and the effect of those cancers on children’s health and functional capacity, including the relative levels of functional limitation typically associated with the cancers and their treatment. This report also provides a summary of selected treatments currently being studied in clinical trials and identifies any limitations on the availability of these treatments, such as whether treatments are available only in certain geographic areas.

Contents

• The National Academies of SCIENCES • ENGINEERING • MEDICINE
• COMMITTEE ON CHILDHOOD CANCERS AND DISABILITY
• Reviewers
• Acknowledgments
• Acronyms and Abbreviations
• Summary
  • STUDY APPROACH AND SCOPE
  • OVERALL CONCLUSIONS
• 1. Introduction
  • CONTEXT FOR THIS STUDY
  • STUDY CHARGE AND SCOPE
  • STUDY APPROACH
  • REPORT ORGANIZATION
  • REFERENCES
• 2. Epidemiology of Childhood Cancer in the United States
  • INCIDENCE
  • MORTALITY AND SURVIVAL
  • CANCER-SPECIFIC INFORMATION
  • ETIOLOGIC RISK FACTORS
  • THERAPY-RELATED MORBIDITY
  • FINDINGS AND CONCLUSIONS
  • REFERENCES
• 3. Treatment Modalities for Childhood Cancers
  • PEDIATRIC COOPERATIVE GROUPS
  • MULTIMODAL THERAPIES
  • STANDARD TREATMENT MODALITIES
  • EMERGING TREATMENTS
  • SUMMARY
  • FINDINGS AND CONCLUSIONS
  • REFERENCES
• 4. Childhood Cancers and Function
  • PHYSICAL FUNCTIONING
  • COGNITIVE FUNCTIONING
  • PSYCHOSOCIAL AND EMOTIONAL FUNCTIONING
  • SUMMARY
  • FINDINGS AND CONCLUSIONS
  • REFERENCES
• 5. Selected Hematologic Malignancies and Histiocytoses
  • OVERVIEW
  • DIAGNOSIS, PROGNOSIS, TREATMENT, AND OUTCOMES BY MALIGNANCY
  • FINDINGS AND CONCLUSIONS
  • REFERENCES
• 6. Selected Central Nervous System Tumors
  • OVERVIEW
  • DIAGNOSIS, PROGNOSIS, TREATMENT, AND OUTCOMES BY TUMOR TYPE
  • FINDINGS AND CONCLUSIONS
  • REFERENCES
• 7. Selected Non–Central Nervous System Solid Tumors
  • OVERVIEW
  • DIAGNOSIS, PROGNOSIS, TREATMENT, AND OUTCOMES BY TUMOR TYPE
  • FINDINGS AND CONCLUSIONS
  • REFERENCES
• 8. The Transition from Adolescence to Young Adulthood
  • THE DISABILITY DETERMINATION PROCESS
  • EPIDEMIOLOGY OF CANCERS IN ADOLESCENTS AND YOUNG ADULTS
  • CLINICAL DIFFERENCES BETWEEN ADOLESCENCE AND YOUNG ADULTHOOD
  • LATE EFFECTS
  • FERTILITY PRESERVATION
  • FUNCTIONAL IMPACTS UNIQUE TO ADOLESCENCE AND YOUNG ADULTHOOD
  • FINDINGS AND CONCLUSIONS
  • REFERENCES
• 9. Overall Conclusions
  • OVERALL CONCLUSIONS
  • SELECTED FINDINGS AND CONCLUSIONS IN SUPPORT OF THE COMMITTEE’S OVERALL CONCLUSIONS
• Appendix A. Public Session Agendas
• Appendix B. Epidemiology and Attributes of Specific Childhood Cancers
• Appendix C. Selected Resources
• Appendix D. Biographical Sketches of Committee Members

Suggested citation:

National Academies of Sciences, Engineering, and Medicine. 2021. Childhood cancer and functional impacts across the care continuum. Washington, DC: The National Academies Press. https://doi.org/10.17226/25944.

Digital Object Identifier: https://doi.org/10.17226/25944

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