An overview of progress in childhood cancer survival.

Survival for children with cancer has continued to improve over the past 20 years, with 5-year survival rates now approaching 80% and with an increasing number of children surviving into adulthood. In recognition of the need to address important issues for survivors of childhood cancer, the National Cancer Institute (NCI) has supported the Childhood Cancer Survivor Study (CCSS) since 1993. The CCSS has established a cohort of over 14,000 5-year survivors of childhood cancer initially diagnosed between 1970 and 1986 and has obtained comprehensive summaries of treatment received by these survivors through abstraction of medical records for chemotherapy, radiation therapy, and surgical procedures. Survivors in the CCSS cohort completed a baseline questionnaire and follow-up questionnaires to provide information about their current status. The CCSS collected buccal cells for DNA isolation from members of the survivor cohort to allow evaluations of the contribution of genetic factors to long-term sequelae of cancer therapy. The CCSS is now poised to expand its contributions through studies designed to gain greater insight into the biological basis for long-term adverse effects of cancer treatment and is enlarging its efforts to include more recently treated cohorts of patients. The experts present at the work group, Moving the Research Agenda Forward for Children With Cancer, offered several possibilities for utilizing CCSS data in expanding research opportunities concerned with cancer survivorship.