Recommendations for the Surveillance of Mental Health Problems


With contemporary therapy, the five-year overall survival rate for childhood, adolescent, and young adult cancer is >80% in North America, parts of Europe, and Australia,1–4 leading to a growing population of survivors worldwide. Following completion of treatment, survivors of childhood, adolescent, and young adult (CAYA) cancer are at risk for a variety of physical and psychosocial late effects. Multiple international cohort studies have found that these survivors are more likely to experience clinically relevant impairments in mental health. Mental health problems are consistently associated with poorer physical health and decreased healthy lifestyle behaviours among survivors. In addition to being essential for quality of life, supporting mental health is fundamental to promoting the long-term physical health of survivors of CAYA cancer.

Clinical practice guidelines (CPGs) developed for North America and Europe recommend survivors receive long-term surveillance for mental health problems after CAYA cancer; however, these CPGs were developed independently and thus differ in recommendations regarding risks, approaches to surveillance, and interventions to address mental health problems among survivors. The aim of this CPG project under the sponsorship of the International Late Effects of Childhood Cancer Guideline Harmonization Group (IGHG) was to harmonize the recommendations for mental health surveillance in survivors of CAYA cancer diagnosed before the age of 25 years.

In conclusion, these recommendations promote the adoption of a “detect and intervene approach” for mental health problems aligned with traditional surveillance for physical late effects in long-term follow-up care. Further, these recommendations highlight the importance of including mental health as a key component of survivor-focused healthcare to mitigate the negative impact of CAYA cancer and support survivors’ quality of life.