Health Care Use of Long-Term Survivors of Childhood Cancer: The British Childhood Cancer Survivor Study

Rebholz, Cornelia E.; Reulen, Raoul C.; Toogood, Andrew; Frobisher, Clare; Lancashire, Emma; Winter, D.; Kuehni, Claudia E.; Hawkins, Michael M.

doi:10.1200/jco.2011.36.5619

Cited by 51 publications

(52 citation statements)

References 11 publications

(18 reference statements)

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“…This indicates a continuing need to manage the long-term effects of radiation therapy in pediatric cancer survivors, including increased risks of secondary malignancy, growth deficiency, and neurocognitive deficits (37). As a result, this growing population will continue with special healthcare needs extending into the foreseeable future (38)(39)(40).…”

Section: Discussionmentioning

confidence: 99%

Trends in Radiation Therapy among Cancer Survivors in the United States, 2000–2030

Bryant

Banegas

Martı́nez

et al. 2017

Cancer Epidemiology, Biomarkers &Amp; Prevention

106

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Background: Although the number of cancer survivors has increased substantially over the past several decades, the composition of survivors treated with radiotherapy is not well defined. Radiotherapy carries unique long-term toxicity risks for cancer survivors. This study describes the current estimates and future projections of the epidemiology of 5-year cancer survivors who receive radiation therapy.Methods: We used cancer incidence and survival data from the Surveillance, Epidemiology, and End-Results (SEER) database linked to U.S. Census data to estimate the number of 5-year cancer survivors treated with radiation between 2000 and 2030. Future projections assumed continuing incidence and survival trends based on historical rates.Results: In 2016, there were an estimated 3.05 million cancer survivors treated with radiation, accounting for 29% of all

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Section: Discussionmentioning

confidence: 99%

Trends in Radiation Therapy among Cancer Survivors in the United States, 2000–2030

Bryant

Banegas

Martı́nez

et al. 2017

Cancer Epidemiology, Biomarkers &Amp; Prevention

106

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“…Leukemia survivors included in the CCSS had a standardized incidence ratio of self-reported hospitalization of 1.4 (95%CI 1.3–1.4) compared with the general U.S. population [16]. In the BCCSS, 7.1 percent of survivors of leukemia reported having been hospitalized at least once during the observed year, a 1.4-fold risk compared with the general population (data from the National General Household Survey) [20]. Thus, the findings of the present study are also consistent with the results of the BCCSS and the CCSS.…”

Section: Discussionmentioning

confidence: 99%

Increased health care utilization by survivors of childhood lymphoblastic leukemia is confined to those treated with cranial or total body irradiation: a case cohort study

et al. 2014

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BackgroundPrevious studies have indicated that survivors of childhood acute lymphoblastic leukemia (ALL) have an increased morbidity measured in terms of health care utilization. However, earlier studies have several potentially important limitations. To overcome some of these, we investigated hospital contact rates, and predictors thereof, among 5-year survivors of ALL in a population-based setting, and compared them to a control cohort regarding outcome measures from a comprehensive nation-wide health register.MethodsAll individuals diagnosed with ALL before the age of 18 in Southern Sweden during 1970–1999 and alive January 2007 (n = 213; male = 107) were identified through the Swedish Cancer Register. Each subject was matched to fifty controls, identified in the Swedish Population Register. All study subjects were linked to the National Hospital Register and detailed information was obtained on all hospital contacts (hospital admissions and outpatients visits) starting five years after cancer diagnosis, and the corresponding date for the controls, until 2009.ResultsThe median follow-up among the 5-year survivors of ALL was 16 years (range 5–33), accruing a total of 3,527 person-years. Of the 213 5-year survivors, 105 (49.3%) had at least one hospital contact compared to 3,634 (34.1%) of the controls (p < 0.001). Survivors had more hospital contacts (3 [1–6] vs. 2 [1–4] contacts, p < 0.001) and more total days in hospital (6 [2–18] vs. 3 [1–7] days, p < 0.001) than the controls during the study period. Logistic regression analysis showed that survivors treated with cranial irradiation and/or total body irradiation (45% and 7%, respectively) had an increased risk of at least one hospital contact (OR 2.3, 95%CI; 1.5–3.6 and OR 11.0, 95%CI; 3.2–50.7, respectively), while there was no significant difference between the non-irradiated survivors and controls.ConclusionsWe show that irradiated survivors of childhood ALL have an increased morbidity measured in terms of hospital contacts, in comparison to non-irradiated survivors and controls, while non-irradiated survivors have not. These findings are encouraging regarding the future morbidity of children currently treated for ALL, as radiotherapy is necessary only for a minority of these.

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“…In 2003, the North American Children’s Oncology Group (COG) published the Long-Term Follow-Up (LTFU) Guidelines for Survivors of Childhood, Adolescent, and Young Adult Cancer, which provide surveillance guidelines based on survivors’ exposure to cancer therapies (11, 15). Yet, more than a decade after the Institute of Medicine report, most CCSs are not engaged in appropriate risk-based health care (16–20). …”

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confidence: 99%

General Internists’ Preferences and Knowledge About the Care of Adult Survivors of Childhood Cancer

Suh¹,

Daugherty²,

Wroblewski³

et al. 2014

Ann Intern Med

140

128

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Background Adult childhood cancer survivors (CCSs) are at high risk for illness and premature death. Little is known about the physicians who provide their routine medical care. Objective To determine general internists’ self-reported attitudes and knowledge about the care of CCSs. Design Cross-sectional survey. Setting Mailed survey delivered between September 2011 and August 2012. Participants Random sample of 2000 U.S. general internists. Measurements Care preferences, comfort levels with caring for CCSs (7-point Likert scale: 1 = very uncomfortable, 7 = very comfortable), familiarity with available surveillance guidelines (7-point Likert scale: 1 = very unfamiliar, 7 = very familiar), and concordance with Children’s Oncology Group Long-Term Follow-Up Guidelines in response to a clinical vignette. Results The response rate was 61.6% (1110 of 1801). More than half the internists (51.1%) reported caring for at least 1 CCS; 72.0% of these internists never received a treatment summary. On average, internists were “somewhat uncomfortable” caring for survivors of Hodgkin lymphoma, acute lymphoblastic leukemia, and osteosarcoma. Internists reported being “somewhat unfamiliar” with available surveillance guidelines. In response to a clinical vignette about a young adult survivor of Hodgkin lymphoma, 90.6% of respondents did not appropriately recommend yearly breast cancer surveillance, 85.1% did not appropriately recommended cardiac surveillance, and 23.6% did not appropriately recommend yearly thyroid surveillance. Access to surveillance guidelines and treatment summaries were identified as the most useful resources for caring for CCSs. Limitation Findings, based on self-report, may not reflect actual clinical practice. Conclusion Although most general internists report involvement in the care of CCSs, many seem unfamiliar with available surveillance guidelines and would prefer to follow patients in collaboration with a cancer center. Primary Funding Source National Cancer Institute.

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Health Care Use of Long-Term Survivors of Childhood Cancer: The British Childhood Cancer Survivor Study

Abstract: We have quantified how excess morbidity experienced by survivors of childhood cancer translates into increased use of health care facilities.

Cited by 51 publications

References 11 publications

Trends in Radiation Therapy among Cancer Survivors in the United States, 2000–2030

Trends in Radiation Therapy among Cancer Survivors in the United States, 2000–2030

Increased health care utilization by survivors of childhood lymphoblastic leukemia is confined to those treated with cranial or total body irradiation: a case cohort study

General Internists’ Preferences and Knowledge About the Care of Adult Survivors of Childhood Cancer

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