In the Netherlands, 500 – 600 children below 18 years are diagnosed with cancer each year, mostly leukemia, central nervous system tumors and lymphomas. Survival following the diagnosis of childhood cancer has significantly improved over the past decades. This progress has resulted in increasing numbers of long-term childhood cancer survivors. Unfortunately, having been exposed to cytotoxic treatments at an early stage in life, childhood cancer survivors are at risk of developing long-term morbidity, such as second neoplasms, organ dysfunction and psychological and cognitive problems. The research presented in this thesis, will give insight in the consequences of long-term survival after childhood cancer. By defining subpopulations of childhood cancer survivors at risk for long term morbidity or excess health care use and giving insight in the underlying types of health conditions, these results will provide information for the development of less toxic treatment protocols for children currently treated for cancer. Also, these results will inform guidelines for long-term morbidity screening programs, which may also include resource planning and prioritization of health care for childhood cancer survivors. In this thesis, of the current landscape of studies focusing on the total burden of physical morbidity in childhood cancer survivors is described and a uniform set of outcomes is proposed. The cumulative burden of morbidity and risk factors were investigated in childhood cancer survivors compared to a sibling control group. Furthermore, both rate of primary care use and hospitalizations, underlying conditions and risk factors were investigated in childhood cancer survivors, compared to control groups.