Barriers and facilitators of risk-based health care for adult survivors of childhood cancer: A report from the Childhood Cancer Survivor Study

Jennifer S. Ford, Emily S. Tonorezos, Ann C. Mertens, Melissa M. Hudson, Jacqueline Casillas, Barbara M. Foster, Chaya S. Moskowitz, Stephanie M. Smith, Joanne F. Chou, George Buchanan, Leslie L. Robison, Kevin C. Oeffinger

Research output: Contribution to journalArticle

1 Scopus citations

Abstract

Background: Optimal risk-based survivor health care includes surveillance for late effects and education targeted at reducing or preventing risky health behaviors. Understanding the reasons for a lack of risk-based follow-up care is essential. Methods: Adult participants from the Childhood Cancer Survivor Study were surveyed about having a cancer-related visit in the past 2 years and the likelihood of having a cancer-related visit in the future. Additional factors thought to be related to the primary outcomes were also assessed. Results: Nine hundred seventy-five survivors completed the survey. Twenty-seven percent (95% confidence interval [CI], 24%-30%) had a cancer-related medical visit in the previous 2 years, and 41% (95% CI, 38%-44%) planned to have such a visit within the next 2 years. The likelihood of having had a cancer-related visit within the last 2 years was higher among survivors assigning greater importance to these visits (relative risk [RR], 1.2; 95% CI, 1.1-1.3), perceiving greater susceptibility to health problems (RR, 1.2; 95% CI, 1.1-1.3), having a moderate to life-threatening chronic health problem related to their cancer (RR, 2.1; 95% CI, 1.7-2.7), seeing a primary care provider for a cancer-related problem (RR, 1.3; 95% CI, 1.0-1.6), having a cancer treatment summary (RR, 1.3; 95% CI, 1.0-1.6), and endorsing greater confidence in physicians' abilities to address questions and concerns (RR, 1.2; 95% CI, 1.0-1.3). Conclusions: Educational interventions improving awareness of treatment history and susceptibility to cancer-related late effects and corresponding risk-based care are likely to be beneficial for survivors of childhood cancers.

Original languageEnglish (US)
Pages (from-to)619-627
Number of pages9
JournalCancer
Volume126
Issue number3
DOIs
StatePublished - Feb 1 2020

Keywords

  • barriers
  • cancer survivor
  • childhood cancer
  • risk-based care

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

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    Ford, J. S., Tonorezos, E. S., Mertens, A. C., Hudson, M. M., Casillas, J., Foster, B. M., Moskowitz, C. S., Smith, S. M., Chou, J. F., Buchanan, G., Robison, L. L., & Oeffinger, K. C. (2020). Barriers and facilitators of risk-based health care for adult survivors of childhood cancer: A report from the Childhood Cancer Survivor Study. Cancer, 126(3), 619-627. https://doi.org/10.1002/cncr.32568