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Predictors of Suboptimal Follow-up in Pediatric Cancer Survivors

Leana May1, David D Schwartz, Ernest Frugé

  • 1*Section of Emergency Medicine, Children's Hospital of Colorado, Aurora, CO †Department of Pediatrics, Section of Psychology ‡Department of Pediatrics, Section of Hematology-Oncology, Texas Children's Cancer Center §Department of Medicine, Section of General Medicine, Baylor College of Medicine, Houston ∥Department of Psychiatry, Pauline Allen Gill Center for Cancer and Blood Disorders, Dallas, TX.

Journal of Pediatric Hematology/Oncology
|December 17, 2016
PubMed

Insights

Many childhood cancer survivors, over half, miss crucial follow-up care. Factors like surgery-only treatment, older age at diagnosis, no stem cell transplant history, and lacking insurance predict poor attendance for pediatric cancer patients.

Area of Science:

  • Pediatric Oncology
  • Cancer Survivorship
  • Health Services Research

Background:

  • Long-term follow-up care is critical for childhood cancer survivors.
  • Attendance to post-treatment follow-up care remains an understudied area.
  • Suboptimal follow-up rates can impact long-term health outcomes.

Purpose of the Study:

  • To identify demographic, clinical, and socioeconomic predictors of follow-up care attendance in pediatric cancer patients.
  • To understand factors associated with patients lost to long-term follow-up.
  • To inform targeted interventions for improving survivorship care.

Main Methods:

  • Retrospective analysis of 442 newly diagnosed pediatric cancer patients at a large center.
  • Multivariable logistic regression was used to analyze predictors of follow-up.
  • Patients not returning for at least 1000 days post-treatment were classified as lost to follow-up.

Main Results:

  • Over half (54.8%) of patients were lost to follow-up.
  • Predictors of being lost to follow-up included: surgery-only treatment (OR=6.7), older age at diagnosis (OR=1.8-4.8), no stem cell transplant history (OR=2), and lack of insurance (OR=3.4).
  • Hispanic patients demonstrated better follow-up rates compared to white and black patients (P=0.03).

Conclusions:

  • Attendance to long-term follow-up care is suboptimal in childhood cancer survivors.
  • Identifying key predictors of non-attendance is essential for developing targeted interventions.
  • Improving follow-up care can enhance long-term health and outcomes for pediatric cancer survivors.

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