Retrospective audit of endocrine late effects in survivors of childhood cancer
M D Balapatabendi, J Srinivasan, J Greening & E Ross
Introduction: The Paediatric Oncology Late Effects Clinic in Leicester was established in 1999, in order to monitor cancer survivors for the development of secondary co-morbidity, including that relating to endocrinopathy from treatment for the underlying oncological diseases.
Aim: As a retrospective audit of our clinical service against the current existing guidelines (UKCSSG, SIGN), specifically to monitor the endocrine standards with respect to axiology, pubertal staging and exclusion of thyroid disease as well as fertility counselling.
Methodology: Retrospective case notes audit was performed in all patients who completed cancer treatment between 19952000. A total of 142 patients were identified: 86 case notes were analysed, 43 patients were excluded from the analysis as they were deceased and 13 sets of notes were unidentified.
Results: Results revealed 52% Leukaemias, 23% lymphomas, 16% solid tumours and others 9%. Vertical height was measured in 71 (83%) of patients, Sitting height in 0% of the at risk patients with craniospinal irradiation. Impaired growth was found in 4 (4.6%) and 1 (1.1%) diagnosed with growth hormone deficiency. Pubertal staging was assessed in 87% of girls and 62% of boys. Received contraception and fertility counselling were documented by 46% of post pubertal girls and 33% of boys. In high risk patients 14% had palpation of the neck with 57% having thyroid function assessed.
Conclusion: The audit demonstrated a lack of compliance with existing guidelines. It identified urgent changes required for the clinical service as well as a benchmark to re audit the service in the light of service developments.