Most pediatric cancer survivors poorly followed

By Megan Rauscher

CHICAGO (Reuters Health) - Data from the Childhood Cancer Survivor Study indicate that the majority of long-term survivors of childhood cancer do not receive the recommended follow-up care, despite the fact that they have a significant risk of developing late side effects of cancer therapy, including heart disease and secondary cancers.

"There is a definite need to educate physicians and childhood cancer survivors about the importance of long-term risk-based follow-up care," Dr. Paul C. Nathan of the Hospital for Sick Children, Toronto, said at the annual meeting of the American Society of Clinical Oncology.

Nathan and colleagues surveyed 8,522 adult survivors of childhood cancer about the health care they received in the previous 2 years. Their average age at the time of cancer diagnosis was 6.8 years - and the average age at the time of the survey was 31.4 years.

Less than one third (32 percent) of those surveyed reported having a visit in the last 2 years with a doctor or nurse who was involved with their previous cancer care.

Only 18 percent said they received risk-based cancer-related care -- meaning the doctor or nurse discussed ways they could reduce their cancer-related risk or had ordered or discussed certain screening tests. Twelve percent had not seen a doctor or nurse for any reason in the preceding 2 years.

Among patients with significantly increased risk of heart disease or breast cancer due to cancer treatment received in childhood, only 28 percent reported receiving an echocardiogram and 49 percent reported having a mammogram, respectively, Nathan reported.

"We were disappointed by these findings," Nathan said. "Only a minority of patients receive recommended screening tests for heart problems and breast cancer."

Adult survivors of childhood cancer at greatest risk for not receiving follow-up care are the uninsured, males, and patients with lower household incomes.