This 2023 study evaluates the long-term surgical burden in survivors of childhood cancer using data from the CCSS cohort, comprising 25,656 survivors diagnosed between 1970–1999 and 5,045 sibling controls. Over a median follow-up of 21.8 years, survivors underwent 28,202 major surgical procedures (≥5 years post-diagnosis under anesthesia) versus 4,110 among