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With better risk assessments, improvements in treatments and optimized supportive care more than 87% of the children with cancer become long-term survivors in Switzerland. Many studies have demonstrated that this enlarging population has a lifelong increased risk of morbidity and mortality associated with the underlying disease and the therapies received. Altogether, two thirds of the survivors will present at least one chronic health condition during their life and for one-third of them, the condition will be severe or life threatening as late effect of their treatment. In this context, a structured long-term follow-up is needed. The aim of this article is to give a global vision of the current situation in Switzerland concerning the different care models proposed to childhood cancer survivors and to provide recommendations for appropriate transition and long-term follow-up care.

Follow-up care is important for childhood cancer survivors to facilitate early detection and treatment of late-effects. We aimed to describe preferences for different organisational aspects and models of followup care among Swiss childhood cancer survivors, and characteristics associated with preferences for different models. We contacted 720 survivors aged 18+ years, diagnosed with cancer after 1990 (age 0-16 years), registered in the Swiss Childhood Cancer Registry (SCCR), and Swiss resident, who previously participated in a baseline survey. They received questionnaires to assess attendance and preferences for follow-up (rated on 4 point scales, 0-3). Clinical information was available from the SCCR. Survivors (n=314: response rate 43.6%; 47.8% still attended follow-up) rated clinical reasons for follow-up higher than supportive reasons (p children’s hospital (mean=1.94, SD=1.11), adult hospital (mean=1.86, SD=0.98) or general practitioner (mean=1.86, SD=1.01) rather than a central specialised late effects clinic (mean=1.25, SD=1.06, p preferred decentralised clinic-based follow-up, rather than one central specialised late effects clinic. Survivors’ preferences should be considered to ensure future attendance

INTRODUCTION: Little is known about the impact of childhood cancer on the personal income of survivors. We compared income between survivors and siblings, and determined factors associated with income. METHODS: As part of the Swiss Childhood Cancer Survivor Study (SCCSS), a questionnaire was sent to survivors, aged ≥18 years, registered in the Swiss Childhood Cancer Registry (SCCR), diagnosed at age 4'500 CHF), even after we adjusted for socio-demographic and educational factors (OR = 0.46, p

Background:Little is known about engagement in multiple health behaviours in childhood cancer survivors.Methods:Using latent class analysis we identified health behaviour patterns in 835 adult survivors of childhood cancer (age 20 35 years) and 1670 age and sex matched controls from the general population. Behaviour groups were determined from replies to questions on smoking drinking cannabis use sporting activities diet sun protection and skin examination.Results:The model identified four health behaviour patterns: 'risk avoidance' with a generally healthy behaviour; 'moderate drinking' with higher levels of sporting activities but moderate alcohol consumption; 'risk taking' engaging in several risk behaviours; and 'smoking' smoking but not drinking. Similar proportions of survivors and controls fell into the 'risk avoiding' (42 vs 44) and the 'risk taking' cluster (14 vs 12) but more survivors were in the 'moderate drinking' (39 vs 28) and fewer in the 'smoking' cluster (5 vs 16). Determinants of health behaviour clusters were gender migration background income and therapy.Conclusion:A comparable proportion of childhood cancer survivors as in the general population engage in multiple health compromising behaviours. Because of increased vulnerability of survivors multiple risk behaviours should be addressed in targeted health interventions.British Journal of Cancer advance online publication 21 June 2012; doi:10.1038/bjc.2012.250 www.bjcancer.com.

Background: In contrast with established evidence linking high doses of ionizing radiation with childhood cancer, research on low-dose ionizing radiation and childhood cancer has produced inconsistent results. Objective: We investigated the association between domestic radon exposure and childhood cancers, particularly leukemia and central nervous system (CNS) tumors. Methods: We conducted a nationwide census-based cohort study including all children < 16 years of age living in Switzerland on 5 December 2000, the date of the 2000 census. Follow-up lasted until the date of diagnosis, death, emigration, a child’s 16th birthday, or 31 December 2008. Domestic radon levels were estimated for each individual home address using a model developed and validated based on approximately 45,000 measurements taken throughout Switzerland. Data were analyzed with Cox proportional hazard models adjusted for child age, child sex, birth order, parents’ socioeconomic status, environmental gamma radiation, and period effects. Results: In total, 997 childhood cancer cases were included in the study. Compared with children exposed to a radon concentration below the median (< 77.7 Bq/m3), adjusted hazard ratios for children with exposure ≥ the 90th percentile (≥ 139.9 Bq/m3) were 0.93 (95% CI: 0.74, 1.16) for all cancers, 0.95 (95% CI: 0.63, 1.43) for all leukemias, 0.90 (95% CI: 0.56, 1.43) for acute lymphoblastic leukemia, and 1.05 (95% CI: 0.68, 1.61) for CNS tumors. Conclusions: We did not find evidence that domestic radon exposure is associated with childhood cancer, despite relatively high radon levels in Switzerland. Citation: Hauri D, Spycher B, Huss A, Zimmermann F, Grotzer M, von der Weid N, Weber D, Spoerri A, Kuehni C, Röösli M, for the Swiss National Cohort and the Swiss Paediatric Oncology Group (SPOG). 2013. Domestic radon exposure and risk of childhood cancer: a prospective census-based cohort study. Environ Health Perspect 121:1239–1244; http://dx.doi.org/10.1289/ehp.1306500

BACKGROUND Cognitive problems can have a negative effect on a person's education, but little is known about cognitive problems in young childhood cancer survivors (survivors). This study compared cognitive problems between survivors and their siblings, determined if cognitive problems decreased during recent treatment periods and identified characteristics associated with the presence of a cognitive problem in survivors. METHODS As part of the Swiss Childhood Cancer Survivor Study, a questionnaire was sent to all survivors, aged 8-20 years, registered in the Swiss Childhood Cancer Registry, diagnosed at age

In severe forms of Diamond-Blackfan anemia, preimplantation genetic diagnosis (PGD) of histocompatibility leukocyte antigen-compatible embryos for enabling the next sibling in the family to be a stem-cell transplantation donor constitutes the sole lasting cure capable of terminating the enduring need for iterative transfusions. We report here an open collaboration between two renowned institutions to provide a family desiring this treatment even though they resided where the preimplantation genetic diagnosis procedure is banned.

Aus der Beschreibung einer schweren hämorrhagischen Diathese bei einem jungen Kind und einer kurzen Übersicht werden die Genetik, Epidemiologie, Pathophysiologie, Klinik und Laboranalytik des Faktor XIII-Mangels erläutert. Die auffälligen klinischen Symptome mit Blutungen seit der Neonatalzeit (Nachblutung nach Nabelschnurabfall), dann schwere, lebensbedrohliche intra-kranielle Blutungen im Kleinkindesalter lassen die Diagnose klinisch stark vermuten. Die Schwierigkeiten der Labordiagnostik (falsch normale Screeningteste) werden vorgestellt und es wird unterstrichen, daß die Gerinnungsanalysen bei klinischem Verdacht wiederholt werden müssen, einschließlich der quantitativen FXIII-Bestimmung, wenn die Screeningteste die klinische Vermutung nicht bestätigen. Die Diagnose des FXIII-Mangels ist aufwendig, hat aber wichtige therapeutische Konsequenzen. Sobald sie steht, sollen die Patienten unter eine Dauersubstitution mit FXIII-Konzentrat gestellt werden: diese Behandlung ist einfach durchzuführen und sehr wirksam.

Follow-up care is important for childhood cancer survivors to facilitate early detection and treatment of late effects. We aimed to describe preferences for different organisational aspects and models of follow-up care among Swiss childhood cancer survivors, and characteristics associated with preferences for different models. We contacted 720 survivors aged 18+ years, diagnosed with cancer after 1990 (age 0-16 years), registered in the Swiss Childhood Cancer Registry (SCCR), and Swiss resident, who previously participated in a baseline survey. They received questionnaires to assess attendance and preferences for follow-up (rated on 4-point scales, 0-3). Clinical information was available from the SCCR. Survivors (n = 314: response rate 43.6%; 47.8% still attended follow-up) rated clinical reasons for follow-up higher than supportive reasons (p

Little is known about engagement in multiple health behaviours in childhood cancer survivors.

Deep vein thrombosis in children and adolescents is a quite rare event. Risk factors most often associated with DVT in this particular population are: central vein catheters, neoplasia, vascular malformations and oral contraception. Diagnosis and management of DVT in adolescents does not differ greatly from that of adults. Compression ultrasound is the initial exam of choice. Hospitalization is often not necessary and treatment can be started by using low molecular weight heparin followed by oral anti-vitamin K antagonists. Thrombophilia screening is not routinely recommended and should be reserved for those patients for whom results would change therapeutical management.