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

Abstract

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.

Long-term diagnosis-specific sickness absence, disability pension, and healthcare use in 1305 young adult childhood cancer survivors and in 6430 references; a Swedish ten-year prospective cohort study

“…Additionally, some CNS tumor survivors had visits due to endocrine and nervous system disorders. Our findings are in line with previous studies that also found a higher risk of outpatient visits [12,13] due to secondary malignancy (neoplasms), endocrine, and neurological conditions [13] among CCS than among references without such medical history.…”

“…However, childhood cancer survivors (CCS) are at higher risk of chronic health conditions compared to individuals without childhood cancer [2][3][4][5][6]. Studies have shown an overall higher risk of hospitalization [7][8][9][10][11][12], outpatient visits [12,13], and prevalence of chronic health conditions (all grades) (as high as 77% of all CCS with an average of 3-4 diagnoses/CCS [2,14]) among CCS compared to among references without childhood cancers. Although the prevalence of chronic health conditions, hospitalization, and outpatient visits is higher among young adult CCS than references, their burden in terms of affected work capacity might vary largely.…”

Late mortality in survivors of childhood cancer in Hungary

“…Survivors can be divided into risk groups and suggestions can be made on their optimal individual care according to available guidelines 31 . However, scarce knowledge and experience of adult specialists on childhood cancer survivorship limit the availability of appropriate services 33,34 . Establishing optimal long-term survivor care is vital to prevent late morbidity and mortality to further improve outcome of childhood cancer.…”

Questionnaire‐ and linkage‐based outcomes in Dutch childhood cancer survivors: Methodology of the DCCSS LATER study part 1

“…Until present, 35 published reports from national and international collaborative studies include data from the LATER 1 study, 6 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 addressing cardiac outcomes, 20 , 21 , 22 , 23 subsequent tumors, 6 , 14 , 15 , 19 , 24 , 25 , 26 , 29 , 33 , 34 , 35 , 42 , 44 , 45 burden of disease, 31 , 32 mort...…”