People who survive cancer during childhood and adolescence are at risk of suffering a serious health condition in later life.

Professor Mike Hawkins is using data collected in the UK from survivors of childhood, teenage and young adult cancer to better determine those at risk of developing a serious illness in the decades after cancer treatment.

Project Details

  • Project Title

    Risk stratification of the national population of survivors of childhood, teenage and young adult cancer for evidence-based clinical follow-up

  • Lead Researcher

    Professor Michael Hawkins

  • Research Centre

    Centre for Childhood Cancer Survivor Studies, University of Birmingham

  • City & Institution Postcode

    Birmingham B15 2TT

  • Start Date

    1 October 2017

  • Duration

    36 months

  • Grant Amount


Mike Hawkins man wearing blue and white stripped shirt smiling at camera


Due to improvements in treatment 80% of people who suffer cancer as a child, teenager or young adult (TYA) will survive beyond five years from diagnosis. However, these survivors are at an increased risk of developing health problems later in life when compared with the general population. In this project Professor Mike Hawkins and his research team will analyse data collected from two national studies of survivors of cancer to thoroughly investigate the risk of developing serious health problem in the years after cancer treatment. The two studies are:
  1. The British Childhood Cancer Survivor Study (BCCSS) which includes 35,000 individuals diagnosed with cancer aged under 15 years, in England, Wales or Scotland, between 1940 and 2006 and who survived at least 5 years from diagnosis
  2. The Teenage and Young Adult Cancer Survivor Study (TYACSS) which includes 200,900 individuals diagnosed with cancer when aged 15 to 39 years, in England and Wales, between 1971 and 2006 and who survived at least 5 years from diagnosis
By using this data, the research team will identify groups of survivors, defined in terms of type of cancer and treatment, who are at low, medium and high risk of developing a serious illness later in life.

What difference will this project make?

Such evidence will help doctors and nurses to plan clinical follow-up of cancer patients after treatment in order to minimise long-term risks . It will also empower survivors by providing them with information about their long-term risks, and provide an unrivalled national evidence-base for:
  • Developing standardised evidence-based clinical follow-up guidelines for doctors and nurses
  • Preparing “survivorship care plans” for survivors by doctors and nurses, summarising the treatments which survivors received and potential side-effects which are associated with those treatments
  • Providing educational material for health care professionals, particularly family doctors
  • Planning the treatments of future patients with a view to reducing ‘side-effects’ experienced after their cancer treatment
  • Advising national health authorities in relation to subgroups of survivors at particularly high risk for consideration of potential recall for counselling, screening or other actions
  • Identify low risk groups for less intensive follow-up and less frequent need to visit hospitals
  • Provide the NHS with evidence useful in preparing “Service Specifications “which enable the risk stratification of individual patients at completion of cancer treatment
  • Providing costs of caring for different subgroups of survivors
  • Providing information on geographical variation in risks of side-effects

About the Research Team

The team is led by Professor Mike Hawkins, an epidemiologist who established the Centre for Childhood Cancer Survivors Studies at the University of Birmingham. Professor Hawkins internationally recognised as a global expert in this area of research. In this project two further researchers will lead most of the day-to-day work. Dr Raoul Reulen will concentrate on those treated for teenage and young adult cancer. Dr Reulen is a led two landmark publications concerned with the risks of specific causes of death and the risks of specific types of new cancers in survivors. Dr Clare Frobisher will concentrate on those treated for childhood cancer. Dr Frobisher has published over 20 research papers in scientific and clinical journals and presented her work at several International and European conferences on the late effects of childhood cancer.
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