Health-related quality of life of long-term childhood cancer survivors: A population-based study from the Childhood Cancer Registry of Piedmont, Italy Daniela Alessi a , Elisa Dama a , Ronald Barr b , Maria Luisa Mosso a , Milena Maule a , Corrado Magnani a,c , Guido Pastore a,d, *, Franco Merletti a a Childhood Cancer Registry of Piedmont, Cancer Epidemiology Unit, CeRMS and CPO-Piemonte, University of Turin, Italy b Division of Haematology-Oncology, Department of Paediatrics, McMaster University, Hamilton, Ontario, Canada c Unit of Medical Statistics and Epidemiology, CPO Piemonte and Department of Medical Sciences, University of Eastern Piedmont, Novara, Italy d Division of Paediatrics, Department of Medical Sciences, University of Eastern Piedmont, Novara, Italy ARTICLE INFO Article history: Received 12 April 2007 Received in revised form 20 July 2007 Accepted 31 July 2007 Available online 14 September 2007 Keywords: Childhood cancer survivors Health-related quality of life Population-based study Cancer registry ABSTRACT Aim of the study: To determine the Health Related Quality of Life (HRQL) in a population- based cohort of long-term survivors of childhood cancer in Piedmont, northwestern Italy. Patients and methods: During 2003, a 15-item Health Utilities Index questionnaire was mailed to 1005 5-year survivors, identified from the population-based Childhood Cancer Registry of Piedmont, to derive scores for overall HRQL and for eight single attributes of health. Score differences were estimated as adjusted prevalence odds ratios. Results: A large majority of long-term survivors had moderately high scores for overall HRQL and for each of the single attributes. Males reported better overall HRQL and less morbidity with respect to dexterity, emotion and pain than females. Survivors diagnosed when they were 10–14 years of age had better overall HRQL and less morbidity with respect to emotion, cognition and pain than younger persons. Long-term survivors of central nervous system (CNS) tumours, retinoblastoma and bone tumours had greater impairment of overall HRQL, vision, ambulation, dexterity, cognition and pain than sur- vivors of other forms of cancer. Conclusion: Many survivors of childhood cancer in Piedmont had fairly good overall HRQL. Greater probability of impaired HRQL was seen for females, survivors of CNS tumours, retino- blastoma and bone tumours, and persons diagnosed before 10 years of age. Ó 2007 Elsevier Ltd. All rights reserved. 1. Introduction Among children aged 1–14 years in high-income countries, malignant tumours are the most frequent cause of death, after congenital malformations and accidents. 1 The effective- ness of therapy for cancer increased 5-year survival rates from 40% in 1970 to 75% in 1990, 2 so that a large majority of childhood cancer patients are cured and reach a full-blown 0959-8049/$ - see front matter Ó 2007 Elsevier Ltd. All rights reserved. doi:10.1016/j.ejca.2007.07.026 * Corresponding author: Present address: Childhood Cancer Registry of Piedmont, Via Santena 7, 10126 Torino, Italy. Tel.: +39 11 6336744; fax: +39 11 6334664. E-mail address: guido.pastore@maggioreosp.novara.it (G. Pastore). EUROPEAN JOURNAL OF CANCER 43 (2007) 2545 – 2552 available at www.sciencedirect.com journal homepage: www.ejconline.com