Key result
Survivorship care plans linked to ~152% greater adherence to breast, skin, and cardiac surveillance.
Why the study?
Adherence to surveillance protocols for second malignant neoplasms and cardiac dysfunction in childhood cancer survivors is suboptimal and factors affecting adherence need evaluation.
Does possession of a survivorship care plan improve adherence to surveillance protocols for cardiac dysfunction and second malignancies in childhood cancer survivors?
Cross-Sectional (n=13,483)
Does possession of a survivorship care plan improve adherence to surveillance protocols for cardiac dysfunction and second malignancies in childhood cancer survivors?
Relative Risk: 2.52 (95% CI 1.59–4.01)
Absolute Event Rate: 22.3% vs 8.1%
Adherence to cardiac and cancer surveillance guidelines among childhood cancer survivors is suboptimal, but possession of a survivorship care plan is associated with significantly better adherence.
Suboptimal adherence to COG surveillance persists in high-risk survivors; leaves open whether SCP possession meaningfully improves screening rates.
PURPOSE To evaluate childhood cancer survivors’ adherence to surveillance protocols for late effects of treatment and to determine the factors affecting adherence. METHODS Between 2014 and 2016, 11,337 survivors and 2,146 siblings in the Childhood Cancer Survivor Study completed a survey ascertaining adherence to Children’s Oncology Group (COG) guidelines for survivors at high risk for second malignant neoplasms or cardiac dysfunction and to the American Cancer Society (ACS) cancer screening guidelines for average-risk populations. Adherence rates and factors affecting adherence were analyzed. RESULTS Median age at diagnosis was 7 years (range, 0-20.9 years), and median time from diagnosis was 29 years (range, 15-47 years). Among high-risk survivors, adherence to COG breast, colorectal, skin, and cardiac surveillance was 12.6% (95% CI, 10.0% to 15.3%), 37.0% (34.1% to 39.9%), 22.3% (21.2% to 23.4%), and 41.4% (40.1% to 42.7%), respectively. Among average-risk survivors, adherence to ACS breast, cervical, and colorectal screening was 57.1% (53.2% to 61.0%), 83.6% (82.7% to 84.5%), and 68.5% (64.7% to 72.2%), respectively. Twenty-seven percent of survivors and 20.0% of primary care providers (PCPs) had a survivorship care plan (SCP). For high-risk survivors, SCP possession was associated with increased adherence to COG breast (22.3% v. 8.1%; prevalence ratio [PR], 2.52; CI, 1.59 to 4.01), skin (34.8% v 23.0%; PR, 1.16; CI, 1.01 to 1.33), and cardiac (67.0% v 33.1%; PR, 1.73; CI, 1.55 to 1.92) surveillance. For high-risk survivors, PCP possession of a SCP was associated only with increased adherence to COG skin cancer surveillance (36.9% v 23.2%; PR, 1.24; CI, 1.08 to 1.43). CONCLUSION Guideline adherence is suboptimal. Although survivor SCP possession is associated with better adherence, few survivors and PCPs have one. New strategies to improve adherence are needed.
No takes yet. Share an insight, caveat, or question.
Yan et al. (2020) conducted a cross-sectional in Childhood cancer (n=13,483). Survivorship care plan (SCP) possession vs. No survivorship care plan was evaluated on Adherence to COG breast surveillance among high-risk survivors (PR 2.52, 95% CI 1.59 to 4.01). Possession of a survivorship care plan was associated with increased adherence to breast (22.3% vs 8.1%; PR 2.52, 95% CI 1.59-4.01), skin, and cardiac surveillance among high-risk cancer survivors.
Synapse has enriched 4 closely related papers on similar clinical questions. Consider them for comparative context: