What is the clinical evidence from this study?

Study design: Cross-Sectional. Population: Cardiovascular care of childhood cancer survivors (n=123). Intervention: Cardiovascular care practices. Primary outcome: Current clinical practice patterns in cardiovascular risk assessment, screening, referral, and management.

What does this research mean for the field?

There is significant global variability in cardiovascular risk assessment, screening, and heart failure management for childhood cancer survivors, with practices differing substantially by medical specialty and resource setting. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

What question did this study set out to answer?

To characterize current global practices in cardiovascular risk assessment, preventive strategies, cardiac screening, cardiology referrals, and heart failure management in childhood cancer survivors.

September 5, 2026Cardio-OncologyOpen Access

Global variability in cardiovascular care of pediatric cancer patients and survivors: survey results from the International Cardio Oncology Society (ICOS)

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Key result

Global survey reveals variable CV care for childhood cancer survivors, with only ~57% addressing lipids.

n=123

Why the study?

Global practices surrounding cardiovascular risk assessment, screening, and management in childhood cancer survivors remain variable and incompletely characterized despite published guidelines.

Population

123 medical practitioners involved in the care of childhood cancer survivors

Design

20-question global survey

Authors

NBNeha BansalPediatric / Congenital Cardiology NKNaomi KhannaColumbia University LKLivia KapustaRadboud University Nijmegen

Discussion

Member takes

Implication

Variability in survivor care discussions signals potential gaps; leaves open optimal standardized protocols pending prospective validation.

Key Points

To characterize current global practices in cardiovascular risk assessment, preventive strategies, cardiac screening, cardiology referrals, and heart failure management in childhood cancer survivors.
Distributed a 20-question survey created by the International Cardio-Oncology Society (ICOS) Pediatric Working Group to medical practitioners caring for childhood cancer survivors.
Summarized responses from 123 unique practitioners (75% pediatric specialists, 72% cardiologists) representing low- and middle-income countries (63%) and high-income countries (36%) using descriptive statistics.
Screening commonly utilized EKG (85%), 2D echocardiography (62%), and myocardial strain imaging (54%), whereas advanced cardiac MRI (18%) was predominantly utilized in high-income countries.
Cardioprotective interventions included lifestyle modifications (56%) and dexrazoxane (45%), with low rates of preemptive ACE inhibitors (18%) or beta blockers (16%), particularly in resource-limited settings.
Heart failure therapy relied heavily on ACE inhibitors (76%) and beta blockers (59%), whereas mineralocorticoid receptor antagonists (9%) and ARNIs (7%) were rarely employed.

Study Design

Type

Cross-Sectional (n=123)

Multicenter

Yes

Structured PICO

Population

123 global medical practitioners, predominantly pediatric specialists and cardiologists, involved in the care of childhood cancer survivors.

Outcome

Current clinical practice patterns in cardiovascular risk assessment, screening, referral, and management

This global survey reveals significant variability in cardiovascular risk discussions, screening, and heart failure management for childhood cancer survivors, highlighting an urgent need for standardized global approaches.

Limitations

Voluntary nature of the survey may introduce response bias
Response options may not reflect the full complexity of clinical decision-making
Unequal representation of subcategories (adult vs. pediatric providers and cardiologists vs. oncologists)
Unmeasured confounding factors such as visit frequency, patient volume, and specific patient age groups seen

Cite This Study

Bansal et al. (2026) conducted a cross-sectional in Cardiovascular care of childhood cancer survivors (n=123). Cardiovascular care practices was evaluated on Current clinical practice patterns in cardiovascular risk assessment, screening, referral, and management. A global survey of 123 practitioners revealed significant variability in cardiovascular care for childhood cancer survivors, with most routinely discussing test results (89%) and hypertension (74%), but fewer addressing lipids (57%).

synapsesocial.com/papers/6a9bd3f16b95aff0620eb3a8 https://doi.org/10.1186/s40959-026-00558-z

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Implication

Variability in survivor care discussions signals potential gaps; leaves open optimal standardized protocols pending prospective validation.

Global variability in cardiovascular care of pediatric cancer patients and survivors: survey results from the International Cardio Oncology Society (ICOS)

Discussion

Member takes

Implication

Key Points

Study Design

Structured PICO

Limitations

Cite This Study

Global variability in cardiovascular care of pediatric cancer patients and survivors: survey results from the International Cardio Oncology Society (ICOS)

Discussion

Member takes

Implication

Key Points

Study Design

Structured PICO

Limitations

Cite This Study

Also Consider

Also Consider