AbstractBackgroundStudies have found associations between cancer therapies and auditory complications, but data are limited on long‐term outcomes and risks associated with multiple exposures.ProcedureThe Childhood Cancer Survivor Study is a retrospective cohort investigating health outcomes of long‐term survivors (5+ years) diagnosed and treated between 1970 and 1986 compared to a randomly selected sibling cohort. Questionnaires were completed by 14,358 survivors of childhood cancer and 4,023 sibling controls. Analysis determined the first occurrence of four auditory conditions in two time periods: diagnosis to 5 years post‐diagnosis, and ≥5 years post‐diagnosis. Multivariable analyses determined the relative risks (RR) and 95% confidence interval (CI) of auditory conditions by treatment exposure.ResultsFive or more years from cancer diagnosis, survivors were at increased risk of problems hearing sounds (RR = 2.3; 95% CI: 1.8–2.8), tinnitus (RR = 1.7; 95% CI: 1.4–2.1), hearing loss requiring an aid (RR = 4.4; 95% CI: 2.8–6.9), and hearing loss in 1 or both ears not corrected by a hearing aid (RR = 5.2; 95% CI: 2.8–9.5), when compared to siblings. Temporal lobe and posterior fossa radiation was associated with these outcomes in a dose‐dependent fashion. Exposure to platinum compounds was associated with an increased risk of problems hearing sounds (RR = 2.1; 95% CI: 1.3–3.2), tinnitus (RR = 2.8; 95% CI: 1.9–4.2), and hearing loss requiring an aid (RR = 4.1; 95% CI: 2.5–6.7).ConclusionsChildhood cancer survivors are at risk of developing auditory complications. Radiation and platinum compounds are determinants of this risk. Follow‐up is needed to evaluate the impact of auditory conditions on quality of life. Pediatr Blood Cancer 2011;57:126–134. © 2011 Wiley‐Liss, Inc.