High Hospitalization Rates in Survivors of Childhood Cancer: A Longitudinal Follow-Up Study Using Medical Record Linkage

Sieswerda, Elske; Font-Gonzalez, Anna; Reitsma, Johannes B.; Dijkgraaf, Marcel G. W.; Heinen, Richard C.; Jaspers, Monique W. M.; Pal, Helena J. van der; Leeuwen, Flora E. van; Caron, Huib N.; Geskus, Ronald B.; Kremer, Leontien C. M.

doi:10.1371/journal.pone.0159518

Cited by 24 publications

(33 citation statements)

References 44 publications

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“…We, moreover, found that most CCS contacted their PCP for benign conditions of the skin and that for skin conditions, CCS contacted their PCP 1.2 times as often as controls. The literature on benign skin conditions in long‐term CCS is scarce, and skin conditions were not known to elevate hospitalization rates in CCS . Our results suggest the importance of investigating the course of disease of different benign skin conditions as compared with the general population, and to determine whether different treatment might be beneficial for CCS.…”

Section: Discussionmentioning

confidence: 86%

“…Subsequent neoplasms and endocrine disorders were also among the most important causes for hospitalization. 17 Hematological conditions did not lead to elevated hospitalization rates in CCS. 17 However, in this study, CCS were over three times more likely to require health care for hematological conditions than controls.…”

Section: Discussionmentioning

confidence: 90%

“…17 Hematological conditions did not lead to elevated hospitalization rates in CCS. 17 However, in this study, CCS were over three times more likely to require health care for hematological conditions than controls. Most frequent hematological conditions in CCS were purpura/coagulation defects and pernicious-/iron deficiency anemia.…”

Section: Discussionmentioning

confidence: 90%

“…Previously, we investigated the hospitalization rates in long‐term CCS. Subsequent neoplasms and endocrine disorders were also among the most important causes for hospitalization . Hematological conditions did not lead to elevated hospitalization rates in CCS .…”

Section: Discussionmentioning

confidence: 90%

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The involvement of primary care physicians in care for childhood cancer survivors

Streefkerk

Heins

Teepen

et al. 2019

Pediatric Blood & Cancer

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Background Childhood cancer survivors (CCS) are at risk of developing long‐term morbidity, which is likely to be presented to a primary care physician (PCP). Therefore, insight into CCS's PCP‐based health care use is needed. We investigated the volume and underlying health problems of PCP‐based health care use and the determinants for PCP‐based health care use in CCS. Procedure Data from a Dutch cohort of 6018 eligible five‐year CCS were linked to the Nivel Primary Care database, which contains detailed data from a representative sample of 10% of all Dutch PCPs. Per CCS, two matched controls were selected. Negative binomial regression was performed to compare the annual number of contacts between CCS and controls, and to identify determinants for PCP‐based care use among CCS. Results This study included 602 CCS and 1204 controls. CCS were 1.3 times more likely to contact their PCP than controls (95% CI, 1.2–1.5), up to 1.5 times at attained age over 40 years (95% CI, 1.2–1.8). CCS were 4.9 times more likely to contact their PCP for new malignancies, 3.1 for hematological conditions, and 2.8 for endocrine conditions. Female sex, higher attained age, and treatment with radiotherapy were determinants for having more PCP contacts. Conclusions PCPs play an important role in care for CCS. CCS use more PCP‐based care than matched controls, mainly for severe conditions such as malignancies, hematological, and endocrine conditions. Our results emphasize the importance of disseminating the current knowledge on long‐term morbidity in CCS and on their optimal follow‐up care among PCPs.

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Section: Discussionmentioning

confidence: 86%

Section: Discussionmentioning

confidence: 90%

Section: Discussionmentioning

confidence: 90%

Section: Discussionmentioning

confidence: 90%

See 2 more Smart Citations

The involvement of primary care physicians in care for childhood cancer survivors

Streefkerk

Heins

Teepen

et al. 2019

Pediatric Blood & Cancer

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“…Studies based upon hospital admissions have shown that the risk of hospitalisation for respiratory conditions are increased for CCS compared to the general population . However, only one of these studies has looked at specific types of admissions for respiratory diseases …”

Section: Introductionmentioning

confidence: 99%

Respiratory morbidity in young people surviving cancer: Population‐based study of hospital admissions, treatment‐related risk factors and subsequent mortality

Smith

Glaser

Peckham

et al. 2019

Intl Journal of Cancer

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Respiratory diseases are a major cause of late morbidity and mortality amongst childhood cancer survivors. This population‐based study investigates respiratory hospital admissions in long‐term survivors of cancers diagnosed in young people to identify specific respiratory morbidities, treatment‐related risks and their relationship to subsequent morbidity and mortality. Population‐based cancer registrations in Yorkshire, England, diagnosed between 1990 and 2011 aged 0–29 years, were linked to inpatient Hospital Episode Statistics (HES) for admissions up to 2017. All 5‐year survivors were included in analysis (n = 4235). Admission rates were compared to age‐ and sex‐ matched general population rates. Competing risk regression models were used to assess associations between treatment exposures and risk of admission. Risk of death after admission was calculated using Cox regression. By age 40, cumulative incidence for an admission for any type of respiratory condition was 49%. Respiratory admission rates were 1.86 times higher in cancer survivors than in the general population (95% Confidence Interval (CI) 1.73–2.01), and varied by respiratory condition and age at diagnosis. Treatment with chemotherapy with known lung toxicity increased the risk of admission for all respiratory conditions (subdistribution Hazard ratio (sHR) = 1.26, 95%CI 1.03–1.53) and pneumonia (sHR = 1.48, 95%CI 1.01–2.17). Subsequent mortality was highest in those admitted for pneumonia compared to other respiratory conditions (28% and 15% respectively). Survivors of childhood and young adult cancer remain at significantly increased risk of respiratory complications several decades after treatment, emphasising the importance for clinical initiatives for prevention, early detection and treatment.

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Risk and associated risk factors of hospitalization for specific health problems over time in childhood cancer survivors: a medical record linkage study

et al. 2017

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Childhood cancer survivors (CCS) experience higher hospitalization rates compared to the general population for neoplasms, circulatory diseases, endocrine/nutritional/metabolic diseases and eye disorders. We studied trends in hospitalization rates and associated patient and treatment‐specific risk factors for diagnosis subgroups among these four diseases. We performed medical record linkage of a ≥5‐year CCS cohort with national registers, and obtained a random reference sample matched on age, gender and calendar year per CCS. For each diagnosis subgroup we compared hospitalization rates and trends over time in CCS and the reference population. Further, we analyzed risk factors for hospitalizations within the four CCS diagnosis groups. We used multivariate Poisson regression for all models. We retrieved hospitalization data from 1382 CCS and 26,583 reference persons. CCS had increased hospitalization rates for almost all diagnosis subgroups examined. Hospitalization rates for endocrine/nutritional/metabolic diseases appeared to increase with longer time since primary cancer diagnosis up to 30 years after primary cancer diagnosis. Survivors initially treated with radiotherapy had increased hospitalization rates for neoplasms (P < 0.001), those initially treated with anthracyclines (2.5 [1.1–5.5]) and radiotherapy to thorax and/or abdomen (9.3 [2.4–36.6]) had increased hospitalization rates for diseases of the circulatory system, and those initially treated with radiotherapy to head and/or neck had increased hospitalization rates for endocrine/nutritional/metabolic diseases (6.7 [3.5–12.7]) and diseases of the eye (3.6 [1.5–8.9]). Our study highlights that long‐term health problems resulting in hospitalizations are still clinically relevant later in life of CCS. The identified treatment‐related risk factors associated with hospitalizations support targeted follow‐up care for these risk groups of CCS.

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High Hospitalization Rates in Survivors of Childhood Cancer: A Longitudinal Follow-Up Study Using Medical Record Linkage

Cited by 24 publications

References 44 publications

The involvement of primary care physicians in care for childhood cancer survivors

The involvement of primary care physicians in care for childhood cancer survivors

Respiratory morbidity in young people surviving cancer: Population‐based study of hospital admissions, treatment‐related risk factors and subsequent mortality

Risk and associated risk factors of hospitalization for specific health problems over time in childhood cancer survivors: a medical record linkage study

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