Follow-up cancer care is underutilized in young adult childhood cancer survivors, study finds


Newswise – Treatments for childhood cancer are increasingly successful, with a 5-year survival rate of over 80%. However, there are many lifelong risks that appear in the years following treatment. Thus, lifelong monitoring is necessary to prevent and reduce the severity of late treatment-related effects. Unfortunately, as survivors age and their risk of late effects increases, commitment to survivor care decreases.

A research team, led by Joel Milam, PhD, professor of epidemiology and biostatistics in the UCI program in public health, examines gaps and disparities in the lifelong follow-up of survivors, including taking a closer look at care plans long-term follow-up. , especially for underserved populations. The study shows that age and ethnicity are associated with inadequate follow-up care in young adult childhood cancer survivors.

The main results showed that Hispanic (vs. non-Hispanic, white) and older survivors were significantly less likely to receive a recent follow-up visit. The conclusions of the study are published in JNCI Cancer Spectrum.

“Long-term follow-up care is essential for managing the health of young cancer survivors and with a growing number of cancer survivors, increased efforts are needed to increase engagement in health care as survivors age. and to minimize ethnic disparities in access, ”Milam said. “We recommend stronger tactics for reaching survivors, including patient and provider education, written treatment summaries, and standardized plans for survivors’ transition from pediatric to adult care. “

To conduct their study, the research team formed a study cohort that they invented Project Forward and invited over 2,000 childhood cancer survivors from a Los Angeles County cancer registry to participate. They recruited 1,166 participants into their cohort who had been diagnosed with stage 2 or above cancer (except brain and melanoma, which included stage 1 or above) between 1996 and 2010 and were now in the mid -20s or mid-forties.

Self-report surveys were received from various socio-demographic backgrounds, on a variety of information including age, race / ethnicity, insurance coverage, indicators of engagement in care health, the ability to manage one’s health, the influence of family and mental health.

“We found that if our participants had insurance, a receipt for a written treatment summary, and discussions with their doctor about long-term care needs, they were more likely to use long-term follow-up care. “, added Milam. “Unfortunately, we also saw that older Hispanics and other ethnic groups were associated with lower risks of recent care, putting them at risk for future health complications.”

Another healthcare gap the researchers pointed out was that more than half of survivors had never received a written summary of cancer treatment. Only 12% of respondents said they had received all of the components of long-term care that were assessed, indicating a need for improvements in the delivery of the full spectrum of survival care.

The research team plans to continue their research and investigation of socio-cultural factors (p.

This work was supported by the National Institute on Minority Health and Health Disparities of the National Institutes of Health and the National Cancer Institute.

Other study authors include Dr David R. Freyer, Kimberly A. Miller, PhD, Jessica Tobin, PhD, Cynthia N. Ramirez, MPH, Anamara Ritt-Olson, PhD, Lourdes Baezconde-Garbanati, PhD, Michael Cousineau , PhD, Denise Modjeski, MS, and Ann S. Hamilton, PhD, all from the Keck School of Medicine at USC; Sapna Gupta, MS, of USC Norris Comprehensive Cancer Center; Katherine Y. Wojcik, PhD, University of Washington; and Dr. Stefanie M. Thomas of the Cleveland Clinic.

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