Hypothalamic-Pituitary and Other Endocrine Surveillance Among Childhood Cancer Survivors

Laura van Iersel, Renee L. Mulder, Christian Denzer, Laurie E. Cohen, Helen A. Spoudeas, Lillian R. Meacham, Elaine Sugden, Antoinette Y.N. Schouten-van Meeteren, Eelco W. Hoving, Roger J. Packer, Gregory T. Armstrong, Sogol Mostoufi-Moab, Aline M. Stades, Dannis van Vuurden, Geert O. Janssens, Cécile Thomas-Teinturier, Robert D. Murray, Natascia Di Iorgi, Sebastian J.C.M.M. Neggers, Joel ThompsonAndrew A. Toogood, Helena Gleeson, Cecilia Follin, Edit Bardi, Lilibeth Torno, Briana Patterson, Vera Morsellino, Grit Sommer, Sarah C. Clement, Deokumar Srivastava, Cecilie E. Kiserud, Alberto Fernandez, Katrin Scheinemann, Sripriya Raman, Kevin C.J. Yuen, W. Hamish Wallace, Louis S. Constine, Roderick Skinner, Melissa M. Hudson, Leontien C.M. Kremer, Wassim Chemaitilly, Hanneke M. van Santen

Research output: Contribution to journalReview articlepeer-review

1 Citation (Scopus)


Endocrine disorders in survivors of childhood, adolescent, and young adult (CAYA) cancers are associated with substantial adverse physical and psychosocial effects. To improve appropriate and timely endocrine screening and referral to a specialist, the International Late Effects of Childhood Cancer Guideline Harmonization Group (IGHG) aims to develop evidence and expert consensus-based guidelines for healthcare providers that harmonize recommendations for surveillance of endocrine disorders in CAYA cancer survivors. Existing IGHG surveillance recommendations for premature ovarian insufficiency, gonadotoxicity in males, fertility preservation, and thyroid cancer are summarized. For hypothalamic-pituitary (HP) dysfunction, new surveillance recommendations were formulated by a guideline panel consisting of 42 interdisciplinary international experts. A systematic literature search was performed in MEDLINE (through PubMed) for clinically relevant questions concerning HP dysfunction. Literature was screened for eligibility. Recommendations were formulated by drawing conclusions from quality assessment of all evidence, considering the potential benefits of early detection and appropriate management. Healthcare providers should be aware that CAYA cancer survivors have an increased risk for endocrine disorders, including HP dysfunction. Regular surveillance with clinical history, anthropomorphic measures, physical examination, and laboratory measurements is recommended in at-risk survivors. When endocrine disorders are suspected, healthcare providers should proceed with timely referrals to specialized services. These international evidence-based recommendations for surveillance of endocrine disorders in CAYA cancer survivors inform healthcare providers and highlight the need for long-term endocrine follow-up care in subgroups of survivors and elucidate opportunities for further research.

Original languageEnglish
Pages (from-to)794-823
Number of pages30
JournalEndocrine reviews
Issue number5
Early online date20 Nov 2021
Publication statusPublished - Oct 2022


  • Adolescent
  • Cancer Survivors
  • Child
  • Endocrine System Diseases/diagnosis
  • Female
  • Humans
  • Hypothalamic Diseases
  • Male
  • Neoplasms/epidemiology
  • Pituitary Diseases
  • Survivors
  • Thyroid Neoplasms
  • Young Adult
  • childhood cancer survivor
  • clinical practice guidelines
  • endocrine complications
  • endocrine late effects
  • radiotherapy late effects


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