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Barriers and facilitators of risk-based health care for adult survivors of childhood cancer: A report from the Childhood Cancer Survivor Study.

Authors
  • Ford, Jennifer S1
  • Tonorezos, Emily S2
  • Mertens, Ann C3
  • Hudson, Melissa M4
  • Casillas, Jacqueline5
  • Foster, Barbara M6
  • Moskowitz, Chaya S2
  • Smith, Stephanie M7
  • Chou, Joanne F2
  • Buchanan, George8
  • Robison, Leslie L4
  • Oeffinger, Kevin C9
  • 1 Hunter College and Graduate Center, City University of New York, New York, New York.
  • 2 Memorial Sloan Kettering Cancer Center, New York, New York.
  • 3 Emory University School of Medicine, Atlanta, Georgia. , (Georgia)
  • 4 St Jude Children's Research Hospital, Memphis, Tennessee.
  • 5 University of California Los Angeles School of Medicine, Los Angeles, California.
  • 6 American Board of Obstetrics and Gynecology, Dallas, Texas.
  • 7 Stanford University School of Medicine, Palo Alto, California.
  • 8 University of Texas Southwestern Medical Center, Dallas, Texas.
  • 9 Duke University, Durham, North Carolina.
Type
Published Article
Journal
Cancer
Publisher
Wiley (John Wiley & Sons)
Publication Date
Feb 01, 2020
Volume
126
Issue
3
Pages
619–627
Identifiers
DOI: 10.1002/cncr.32568
PMID: 31626337
Source
Medline
Keywords
Language
English
License
Unknown

Abstract

Optimal risk-based survivor health care includes surveillance for late effects and education targeted at reducing or preventing risky health behaviors. Understanding the reasons for a lack of risk-based follow-up care is essential. Adult participants from the Childhood Cancer Survivor Study were surveyed about having a cancer-related visit in the past 2 years and the likelihood of having a cancer-related visit in the future. Additional factors thought to be related to the primary outcomes were also assessed. Nine hundred seventy-five survivors completed the survey. Twenty-seven percent (95% confidence interval [CI], 24%-30%) had a cancer-related medical visit in the previous 2 years, and 41% (95% CI, 38%-44%) planned to have such a visit within the next 2 years. The likelihood of having had a cancer-related visit within the last 2 years was higher among survivors assigning greater importance to these visits (relative risk [RR], 1.2; 95% CI, 1.1-1.3), perceiving greater susceptibility to health problems (RR, 1.2; 95% CI, 1.1-1.3), having a moderate to life-threatening chronic health problem related to their cancer (RR, 2.1; 95% CI, 1.7-2.7), seeing a primary care provider for a cancer-related problem (RR, 1.3; 95% CI, 1.0-1.6), having a cancer treatment summary (RR, 1.3; 95% CI, 1.0-1.6), and endorsing greater confidence in physicians' abilities to address questions and concerns (RR, 1.2; 95% CI, 1.0-1.3). Educational interventions improving awareness of treatment history and susceptibility to cancer-related late effects and corresponding risk-based care are likely to be beneficial for survivors of childhood cancers. © 2019 American Cancer Society.

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