Many childhood cancer survivors do not adhere to recommended surveillance, according to a study published online March 11 in CMAJ, the journal of the Canadian Medical Association.
Jennifer Shuldiner, Ph.D., from the Women’s College Hospital Institute for Health System Solutions and Virtual Care in Toronto, and colleagues used health care administrative data from Ontario, Canada, to identify adult survivors of childhood cancer diagnosed between 1986 and 2014 who had an elevated risk for therapy-related colorectal cancer, breast cancer, or cardiomyopathy.
Overall, 10, 7, and 99 percent of the 3,241 survivors had an increased risk for colorectal cancer, breast cancer, and cardiomyopathy, respectively. The researchers found that as of February 2020, only 13, 6, and 53 percent were adherent to recommended surveillance within these cohorts. The proportion of time spent adherent was 14, 10, and 43 percent for survivors at elevated risk for colorectal cancer, breast cancer, and cardiomyopathy, respectively, during a median follow-up of 7.8 years. Across the risk groups, there was variation observed in significant predictors of adherence; there was an association seen for higher comorbidity with adherence to recommended surveillance.
“To increase surveillance among this elevated-risk population, screening recommendations need to consider and address barriers to completing surveillance tests,” the authors write. “Surveillance approaches that meet the needs of survivors and their physicians are important to help childhood cancer survivors stay healthy in adulthood.”
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