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J Clin Oncol. 2016 Oct 1;34(28):3440-50. doi: 10.1200/JCO.2015.64.3288. Epub 2016 Jul 25.

Recommendations for Premature Ovarian Insufficiency Surveillance for Female Survivors of Childhood, Adolescent, and Young Adult Cancer: A Report From the International Late Effects of Childhood Cancer Guideline Harmonization Group in Collaboration With the PanCareSurFup Consortium.

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Wendy van Dorp and Sebastian J. Neggers, Erasmus University Medical Centre; Wendy van Dorp, Sophia Children's Hospital, Rotterdam; Renée L. Mulder and Leontien C.M. Kremer, Emma Children's Hospital and Academic Medical Centre; Marleen H. van den Berg, Eline van Dulmen-den Broeder, and Cornelis B. Lambalk, Vrije Universiteit Medical Center, Amsterdam; Marry M. van den Heuvel-Eibrink, Princess Maxima Center for Pediatric Oncology; Hanneke M. van Santen, Wilhelmina Children's Hospital, University Medical Center, Utrecht, the Netherlands; Melissa M. Hudson, St Jude Children's Research Hospital, Memphis, TN; Jennifer M. Levine, Columbia University Medical Center; Kevin C. Oeffinger, Memorial Sloan Kettering Cancer Center, New York; Louis S. Constine, University of Rochester Medical Center, Rochester, NY; Natascia di Iorgi, University of Genoa; Riccardo Haupt, Istituto Giannina Gaslini, Genoa; Andreas Corrias and Alesandro Mussa, University of Turin, Turin; Alberto Revelli, S. Anna Hospital and University of Torino, Torino, Italy; Assunta Albanese, St George's University Hospitals NHS Foundation Trust; Gill Levitt and Alison Leiper, Great Ormond St Hospital for Children NHS Foundation Trust, London; Roderick Skinner, Great North Children's Hospital and Newcastle University, Newcastle upon Tyne; Andrew Toogood, Queen Elizabeth Hospital Birmingham, University Hospitals Birmingham NHS Foundation Trust, Birmingham; William H. Wallace, Royal Hospital for Sick Children, Edinburgh, United Kingdom; Saro H. Armenian, City of Hope, Duarte, CA; Smita Bhatia and Wendy Landier, University of Alabama at Birmingham, Birmingham, AL; Rebecca Deans, University of New South Wales, Sydney, New South Wales, Australia; Uta Dirksen, Westfalian Wilhelms University Muenster, University Hospital Muenster, Germany; Clarisa R. Gracia, University of Pennsylvania, Philadelphia, PA; Lars Hjorth, Skåne University Hospital and Lund University, Lund, Sweden; Leah Kroon, Seattle Children's Hospital, Seat



Female survivors of childhood, adolescent, and young adult (CAYA) cancer who were treated with alkylating agents and/or radiation, with potential exposure of the ovaries, have an increased risk of premature ovarian insufficiency (POI). Clinical practice guidelines can facilitate these survivors' access to optimal treatment of late effects that may improve health and quality of survival; however, surveillance recommendations vary among the existing long-term follow-up guidelines, which impedes the implementation of screening.


The present guideline was developed by using an evidence-based approach and summarizes harmonized POI surveillance recommendations for female survivors of CAYA cancer who were diagnosed at age < 25 years. The recommendations were formulated by an international multidisciplinary panel and graded according to the strength of the evidence and the potential benefit gained from early detection and intervention. The harmonized POI surveillance recommendations were developed by using a transparent process and are intended to facilitate care for survivors of CAYA cancer.


The harmonized set of POI surveillance recommendations is intended to be scientifically rigorous, to positively influence health outcomes, and to facilitate the care for female survivors of CAYA cancer.

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