Long-term outcome after adult-onset cancer.

Over the past four decades increasingly effective cancer therapies have been developed, involving surgery, radiotherapy and chemotherapy. With an 60% 5-year relative survival for cancer patients (all sites combined) the prevalence of long-term cancer survivors (‡5 years after diagnosis) is 3% [1]. In Europe, patients with breast cancer dominate among 10-year survivors, followed by survivors after uterine cancer and digestive tract cancer (Table 1), with similar estimates from the USA [2]. Surveys have revealed cancer-type and treatmentspecific adverse health conditions [3, 4]. Though the present review discusses surgery, radiotherapy, chemotherapy and hormone treatment separately, today’s combined treatment often increases the risk of late somatic toxicity after adult-onset cancer. Further, clinicians must consider genetic variations of clastogenic events [5] and of lifestyle and socio-demographic factors as reasons of inter-individual variability.