Survivors of childhood cancer may go on to face long-term health problems, according to research.
Survival rates are improving for childhood cancers
US scientists discovered they were more than three times as likely to suffer chronic health conditions compared with their cancer-free counterparts.
And they were about eight times as likely to suffer a severe or life-threatening condition.
Writing in the New England Journal of Medicine, the team called for continued medical surveillance for survivors.
Survival rates for paediatric cancer have been increasing over the past few decades thanks to improving treatments and currently stand at about 80%.
To investigate the long-term impacts of the disease, researchers looked at more than 10,000 adults who had survived cancer in their childhood and compared them with about 3,000 of their siblings who had not suffered childhood cancer.
The researchers discovered a marked difference between the two groups.
The cancer survivors, who had all been diagnosed with cancer between 1970 and 1986, were more vulnerable to second cancers, heart conditions, kidney disease, musculoskeletal problems, osteoporosis and sterility.
Survivors of bone tumours, central nervous system tumours and Hodgkin's disease were the most prone to longer term health conditions and were likely to suffer multiple conditions.
And female survivors were at greater risk of chronic conditions than the male survivors.
Dr Anna Meadows, one of the authors on the paper and medical director of the Cancer Survivorship Program at the Children's Hospital of Philadelphia, said the study findings revealed there was a greater need for continued medical surveillance of this group.
She said: "Fewer than 20% of these patients are followed by an oncologist or at a cancer centre, but they clearly have special medical needs and higher risks."
But the authors added that people treated in the 1970s and 1980s were a "high-risk" population because of the combinations of treatments used at the time.
They predict that people treated after this time would face fewer health consequences.
'Key point raised'
Dr Bruce Morland, head of the UK Children's Cancer and Leukaemia Group, supported by Cancer Research UK, said: "This study represents an important contribution to our understanding of the long-term effects of treatment of childhood cancer.
"However, we are now more familiar with these risks, and specialists involved in the care of children with cancer are as determined to reduce the long-term effects of treatment as they are to further improving survival.
"The researchers looked at the effects of treatments available in the 1970s but modern treatments available today significantly reduce the risks of long-term effects.
"Dr Meadows raises a key point in her paper. It is absolutely essential for long-term survivors of childhood cancer to remain under life-long close medical supervision from appropriately trained teams of health professionals."