The reported late effects experienced by childhood cancer survivors treated in Singapore: A clinical audit.

IntroductionKnowledge of late effects after oncological treatment in Southeast Asia remains limited. This study is among the first comprehensive audits of late effects experienced by paediatric cancer survivors from the long-term follow-up (LTFU) clinic at KK Women's and Children's Hospital in Singapore, between September 2017 and December 2023.MethodA total of 485 survivors were examined, all of whom had at least 2 years of treatment and 5 years of remission. Data on cancer diagnoses, treatments and late effects were analysed, with severity classified by the Common Terminology Criteria for Adverse Events (CTCAE) version 5.0.ResultsThe analysis showed 394 survivors (81%) experienced at least 1 late effect. Body mass index ≥23 kg/m2 or ≥90th percentile, low bone mineral density (e.g. Z-score ≤-2.0 standard deviation score) and hearing difficulties were observed in 149 (30.7%), 87 (17.9%) and 73 (15.1%) survivors, respectively. Leukaemia survivors' detection of their first late effect was 10-14 years postdiagnosis, while central nervous system (CNS) and solid tumour survivors detected their first late effect within ≤5 years. Majority of late effects were of mild CTCAE severity. The odd ratio of developing late effects in the first 5 years post-diagnosis was 4.88 (95% confidence interval 2.98-7.71, P