Predictors of Suboptimal Follow-up in Pediatric Cancer Survivors

---

Copy For Citation

May L., Schwartz D. D., Fruge E., Laufman L., Holm S., Kamdar K., ...More

JOURNAL OF PEDIATRIC HEMATOLOGY ONCOLOGY, vol.39, no.3, 2017 (SCI-Expanded)

• Publication Type: Article / Article
• Volume: 39 Issue: 3
• Publication Date: 2017
• Doi Number: 10.1097/mph.0000000000000723
• Journal Name: JOURNAL OF PEDIATRIC HEMATOLOGY ONCOLOGY
• Journal Indexes: Science Citation Index Expanded (SCI-EXPANDED), Scopus
• Keywords: childhood cancer, late effects, clinic attendance, survivorship, LONG-TERM SURVIVORS, CHILDHOOD-CANCER, ADULT SURVIVORS, HEALTH-CARE, MEDICAL-CARE, ATTENDANCE, ADHERENCE, DIAGNOSIS, KNOWLEDGE, OUTCOMES
• Istanbul University Affiliated: No

Abstract

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.