Access to Pediatric Cancer Care by Age, Race, and Diagnosis, and Outcomes of Cancer Treatment in Pediatric and Adolescent Patients in the State of Georgia

Howell, Della L.; Ward, Kevin C.; Austin, Harland; Young, John L.; Woods, William G.

doi:10.1200/jco.2006.07.6992

Cited by 89 publications

(78 citation statements)

References 18 publications

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“…For example, children's hospitals have providers and equipment needed to perform complex invasive procedures to treat CHD, [16][17][18]22,37 and standardized, multiinstitutional protocols used by pediatric oncologists lead to better outcomes among young adults with leukemia compared with patients of the same age treated by providers trained to provide care to adult patients. 25 When specific disease categories are compared, a complex landscape emerges. The CF community has an explicit program to facilitate the transition of patients to adult providers.…”

Section: Discussionmentioning

confidence: 99%

Adults With Chronic Health Conditions Originating in Childhood: Inpatient Experience in Children's Hospitals

et al. 2011

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WHAT'S KNOWN ON THIS SUBJECT:Health care innovations have improved survival in children with conditions previously fatal in childhood. Implications for specific diseases have been reported, but little information is available on disease comparisons or population increases in adult survivors of childhood illness. WHAT THIS STUDY ADDS:In this study of adults with chronic childhood diseases treated at 30 children's hospitals over a 10-year period, 6 conditions were compared and patient population growth was projected. The disparity between diagnoses suggests the existence of systemic barriers to the transition of these patients to adult health care providers. abstract OBJECTIVE: To describe the rate of increase of the population of adults seeking care as inpatients in children's hospitals over time. PATIENTS AND METHODS:We analyzed data from January 1, 1999, to December 31, 2008, from patients hospitalized at 30 academic children's hospitals, including growth rates according to age group (pediatric: aged Ͻ18 years; transitional: aged 18 -21 years; or adult: aged Ͼ21 years) and disease. RESULTS:There were 3 343 194 hospital discharges for 2 143 696 patients. Transitional patients represented 2.0%, and adults represented 0.8%, totaling 59 974 patients older than 18 years. The number of unique patients, admissions, patient-days, and charges increased in all age groups over the study period and are projected to continue to increase. Resource use was disproportionately higher in the older ages. The growth of transitional patients exceeded that of others, with 6.9% average annual increase in discharges, 7.6% in patient-days, and 15% in charges. Chronic conditions occurred in 87% of adults compared with 48% of pediatric patients. Compared with pediatric patients, the rates of increase of inpatient-days increased significantly for transitional age patients with cystic fibrosis, malignant neoplasms, and epilepsy, and for adults with cerebral palsy. Annual growth rates of charges increased for transitional and adult patients for all diagnoses except cystic fibrosis and sickle cell disease. CONCLUSIONS:The population of adults with diseases originating in childhood who are hospitalized at children's hospitals is increasing, with varying disease-specific changes over time. Our findings underscore the need for proactive identification of strategies to care for adult survivors of pediatric diseases. Pediatrics 2011;128:5-13

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Section: Discussionmentioning

confidence: 99%

Adults With Chronic Health Conditions Originating in Childhood: Inpatient Experience in Children's Hospitals

et al. 2011

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“…Nevertheless, a substantial number of AYA patients with pediatric malignancies are not being treated at pediatric cancer centers. 22,42,43 The treatment and appropriate location of care vary with the type of cancer as well as with the availability of family, community, and institutional support. 8,44 Most importantly, AYA patients should be evaluated at medical centers with extensive experience in treating cancer in this patient population and at centers that have access to supportive care services (psychosocial/educational support and fertility preservation) specific to the AYA population as well as to medical subspecialty services appropriate to the cancer diagnosis, such as orthopedic surgeons with experience in limb-sparing surgery for patients with extremity sarcomas.…”

Section: Age-appropriate Carementioning

confidence: 99%

Adolescent and Young Adult Oncology, Version 2.2018, NCCN Clinical Practice Guidelines in Oncology

Coccia¹,

Pappo²,

Beaupin³

et al. 2018

J Natl Compr Canc Netw

252

194

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“…Studies have estimated that approximately twothirds of 15-to 19-year-olds are never seen at pediatric centers. 4,11,12 In a population-based cancer registry study, Albritton et al 4 found that, whereas nearly all children under age 10 were seen at pediatric centers, the rate dropped to 34% between 15 and 19 years of age. Furthermore, only 40% of these AYAs were seen at academic sites; 47% were seen at community American College of Surgeons-accredited cancer centers, and 13% were never seen at American College of Surgeons centers.…”

Section: Where Are Ayas With Cancer Currently Being Seen?mentioning

confidence: 99%

Influencing Referral of Adolescents and Young Adults With Cancer to Sites With Higher Rates of Trial Enrollment

Albritton

Coccia

2014

Pediatrics

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Adolescents and young adults (AYAs) have lower rates of clinical trial enrollment than younger or older patients with cancer. Multiple approaches to change policy and practice need to be used to improve this statistic. This article examines the option of increasing referral to 3 types of centers that are known to have relatively higher rates of enrollment of AYAs: pediatric cancer centers, AYA oncology programs, and National Cancer Institute-designated cancer centers. There are reasonable challenges to changing referral patterns, and more research, as well as education of those diagnosing AYAs, is required.

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Access to Pediatric Cancer Care by Age, Race, and Diagnosis, and Outcomes of Cancer Treatment in Pediatric and Adolescent Patients in the State of Georgia

Abstract: Adolescent-aged patients are less likely to be referred to a COG institution, potentially exposing them to worse outcomes in some cancer subtypes. Reassuringly, minority populations are receiving adequate access to pediatric cancer care; unfortunately their survival rates are lower.

Cited by 89 publications

References 18 publications

Adults With Chronic Health Conditions Originating in Childhood: Inpatient Experience in Children's Hospitals

Adults With Chronic Health Conditions Originating in Childhood: Inpatient Experience in Children's Hospitals

Adolescent and Young Adult Oncology, Version 2.2018, NCCN Clinical Practice Guidelines in Oncology

Influencing Referral of Adolescents and Young Adults With Cancer to Sites With Higher Rates of Trial Enrollment

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