Adherence to Surveillance for Second Malignant Neoplasms and Cardiac Dysfunction in Childhood Cancer Survivors: A Childhood Cancer Survivor Study

• DOI: 10.1200/jco.19.01825
• Publication Date: 2020-03-06T21:05:00Z
• Authors: Adam P. Yan; Yan Chen; Tara O. Henderson; Kevin C. Oeffinger; Melissa M. Hudson; Todd M. Gibson; Joseph P. Neglia; Wendy M. Leisenring; Kirsten K. Ness; Jennifer S. Ford; Leslie L. Robison; Gregory T. Armstrong; Yutaka Yasui; Paul C. Nathan
• Keywords: Cog; Cancer survivor

To evaluate childhood cancer survivors' adherence to surveillance protocols for late effects of treatment and determine the factors affecting adherence.Between 2014 2016, 11,337 survivors 2,146 siblings in Childhood Cancer Survivor Study completed a survey ascertaining Children's Oncology Group (COG) guidelines at high risk second malignant neoplasms or cardiac dysfunction American Society (ACS) screening average-risk populations. Adherence rates were analyzed.Median age diagnosis was 7 years (range, 0-20.9 years), median time from 29 15-47 years). Among high-risk survivors, COG breast, colorectal, skin, 12.6% (95% CI, 10.0% 15.3%), 37.0% (34.1% 39.9%), 22.3% (21.2% 23.4%), 41.4% (40.1% 42.7%), respectively. ACS cervical, colorectal 57.1% (53.2% 61.0%), 83.6% (82.7% 84.5%), 68.5% (64.7% 72.2%), Twenty-seven percent 20.0% primary care providers (PCPs) had survivorship plan (SCP). For SCP possession associated with increased breast (22.3% v. 8.1%; prevalence ratio [PR], 2.52; 1.59 4.01), skin (34.8% v 23.0%; PR, 1.16; 1.01 1.33), (67.0% 33.1%; 1.73; 1.55 1.92) surveillance. PCP only (36.9% 23.2%; 1.24; 1.08 1.43).Guideline is suboptimal. Although survivor better adherence, few PCPs have one. New strategies improve are needed.