Predictors of Suboptimal Follow-up in Pediatric Cancer Survivors

Leana May, David D. Schwartz, Ernest Frugé, Larry Laufman, Suzanne Holm, Kala Kamdar, Lynnette Harris, Julienne Brackett, Sule Unal, Gulsah Tanyildiz, Rosalind Bryant, Hilary Suzawa, Zoann Dreyer, M. Fatih Okcu

Research output: Contribution to journalArticlepeer-review

6 Scopus citations


Attendance to follow-up care after completion of cancer treatment is an understudied area. We examined demographic, clinical, and socioeconomic predictors of follow-up by pediatric cancer patients at a large center in 442 newly diagnosed patients using multivariable logistic regression analyses. Patients who did not return to clinic for at least 1000 days were considered lost to follow-up. Two hundred forty-two (54.8%) patients were lost. In multivariable analyses, the following variables were independent predictors of being lost to follow-up: treatment with surgery alone (odds ratio [OR]=6.7; 95% confidence interval [CI], 3.1-14.9), older age at diagnosis (reference, 0 to 4; ages, 5 to 9: OR=1.8, 95% CI, 1.1-3; ages, 10 to 14: OR=3.3; CI, 1.8-6.1; and ages, 15 and above: OR=4.8; CI, 2.1-11.7), lack of history of stem cell transplantation (OR=2, 95% CI, 1.04-3.7) and lack of insurance (OR=3.4; CI, 1.2-9.2). Hispanic patients had the best follow-up rates (53.7%) compared to whites and blacks (P=0.03). Attendance to long-term follow-up care is suboptimal in childhood cancer survivors. Predictors that were associated with nonattendance can be used to design targeted interventions to improve follow-up care for survivors of pediatric cancer.

Original languageEnglish (US)
Pages (from-to)e143-e149
JournalJournal of Pediatric Hematology/Oncology
Issue number3
StatePublished - 2017


  • childhood cancer
  • clinic attendance
  • late effects
  • survivorship

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Hematology
  • Oncology


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