Medical and Pediatric Oncology 32:403 (1999) EDITORIAL A Special Niche for MPO Medical and Pediatric Oncology (MPO) offers a particular opportunity to bridge the age gap and provide a forum for discussion of issues relevant to adult survivors of cancer in childhood and adolescence, who represent an expanding population . (See the article on pp 404–410 of this issue for an overview of the special circumstances surrounding the adolescent with cancer.) The litany of late effects, to which children and adolescents cured of cancer are prone [2,3], places unusual and additional demands on health care systems and the professionals who provide them. In addition to specific morbidities, these survivors face challenges with respect to employability and insurability, all of which impact on quality of life . Recognition of the importance of these matters, which reflect what Dr. Jan van Eys has termed an “epidemic of survival” , is embodied in the establishment of the Office of Cancer Survivorship, at the National Cancer Institute, initiated under the direction of yet another prominent pediatric oncologist—Dr. Anna Meadows—who has properly asserted that “continued surveillance of childhood cancer survivors is good medicine” . But who will rise to meet these challenges? In a recent report, Oeffinger et al.  describe the results of their survey of member institutions of the Pediatric Oncology Group and the Children’s Cancer Group. Barriers to effective long-term care were compounded by lack of “multidisciplinary transition programs,” for which positive experience exists in other disease entities . The operation of long-term follow-up (“late effects” or “after care”) clinics remains largely the province of children’s hospitals, staffed predominantly by pediatric oncologists and nurse practitioners. At least half of the adult survivors of cancer in childhood and adolescence do not avail themselves of such services , suggesting a considerable need for education of this at-risk population and the community of health care providers. Furthermore, the opportunities for research in this population abound. It has been proposed that, in addressing these and related issues, cancer societies could and should play an important role in stimulating research and assisting support activities . In the context of industrialized societies, Dr. Archie Bleyer has presented evidence that, when expressed as the number of person-years of potential life saved, malignant diseases in the young rank second only to breast cancer . As the cure rate for cancer in childhood and adolescence now approximates 70% overall  in these societies, so there is an increasing need to give voice to © 1999 Wiley-Liss, Inc. the advocates of pediatric oncology, including the population of long-term survivors—a role for which MPO is particularly well placed. Issues such as access to after care, provision and costs of services, education and interventional strategies , outcomes research, and a host of others that focus on this special population provide fertile ground for discussion and study. By publishing the proceedings of the biennial international conferences on late effects in survivors of cancer in childhood , MPO has laid claim to this topic as an editorial priority. The journal wishes to expand its coverage of these topics through publication of articles pertaining to these areas of public health. They include cancer control measures for adolescents, the special needs and concerns of adolescents who have cancer, and the status of adult survivors of cancer in childhood and adolescence. In so doing, MPO will encourage submissions from medical and pediatric constituencies alike and thereby contribute to the resolution of the challenges facing a burgeoning sector of our general population. Ronald D. Barr, MB, ChB, MD, FRCP(Glasg), FRCP, FACP, FRCPath, FRCP(C) McMaster University and Children’s Hospital Hamilton Health Sciences Corporation Hamilton, Ontario, Canada REFERENCES 1. Bleyer WA. The impact of childhood cancer on the United States and the world. CA Cancer J Clin 1990;40:355–367. 2. Blatt J. Studying survivors of childhood cancer for late effects of therapy. Int J Pediatr Hematol Oncol 1995;2:325–336. 3. Hawkins MM, Stevens MCG. The long-term survivors. Br Med Bull 1996;52:898–923. 4. Bradlyn AS, Ritchey AK, Harris CV, et al. Quality of life research in pediatric oncology: research methods and barriers. Cancer 1996;78:1333–1339. 5. Van Eys J. The truly cured child? Pediatrician 1991;18:90–95. 6. Meadows AT. Curing cancer in children: minimizing price, maximizing value. J Clin Oncol 1995;13:1837–1839. 7. Oeffinger KC, Eshelman DA, Tomlinson GE, Buchanan GB. Programs for adult survivors of childhood cancer. J Clin Oncol 1998; 16:2864–2867. 8. Haase GH, Mauer AM, Reaman GH. Survivorship in childhood cancer. Cancer 1998;83:821–823. 9. Harras A, editor. Cancer rates and risks, 4th ed. Bethesda, MD: National Cancer Institute; 1996. 10. Hudson MM, Tyc VL, Jayawardene DA, et al. The feasibility of implementing health promotion interventions to improve healthrelated quality of life. Int J Cancer (in press). 11. Green DM, editor. Fourth International conference on long-term complications of treatment of children and adolescents for cancer. Med Pediatr Oncol 1998;1(Suppl):1–78.