Maeda Naoko, Horibe Keizo, Kato Koji, Kojima Seiji, Tsurusawa Masahito
Department of Pediatrics, National Hospital Organization Nagoya Medical Center, Naka-ku, Nagoya, Japan.
Pediatr Int. 2010 Oct;52(5):806-12. doi: 10.1111/j.1442-200X.2010.03158.x.
Childhood cancer cure rates have increased remarkably; however, survivors face an increased risk of morbidity and mortality. Survivors may benefit from anticipatory guidance and periodic surveillance to minimize morbidity and mortality.
Subjects included 114 5-year survivors of childhood cancer who were diagnosed and treated in three hospitals in Nagoya between 1975 and 2001 and who stopped follow-up physician visits during the preceding 2 years. We conducted a survey of their socioeconomic status, knowledge about their diagnosis and late effects of treatment received, and current hospital attendance patterns.
Eighty-eight of 114 subjects replied. Sixty-six survivors knew about their disease, but only 26 knew about possible late effects of cancer treatment. Although 78 respondents indicated they were healthy and had no trouble in their daily lives, 46 had at least one chronic condition. In response to the question regarding why they did not visit the hospital regularly, many subjects responded that the physician-in-charge told them they did not need to visit the hospital anymore; others thought it was unnecessary to consult a physician because they were in good health.
Some cancer survivors who stop follow-up physician visits may still be suffering from cancer-related illnesses. Both survivor-related and physician-related barriers contribute to cancer survivors stopping follow-up physician visits. To ensure that survivors undergo appropriate follow-up visits, it is necessary to educate survivors, their families, and medical staff about the late effects of cancer and its treatment and the importance of long-term follow up.
儿童癌症治愈率显著提高；然而，幸存者面临的发病和死亡风险却有所增加。幸存者可能会从预防性指导和定期监测中受益，以尽量降低发病和死亡风险。
研究对象包括114名儿童癌症5年幸存者，他们于1975年至2001年期间在名古屋的三家医院被诊断并接受治疗，且在前两年停止了随访就诊。我们对他们的社会经济状况、对自身诊断及所接受治疗的晚期影响的了解情况以及当前的就诊模式进行了调查。
114名研究对象中有88人回复。66名幸存者知道自己的病情，但只有26人知道癌症治疗可能产生的晚期影响。尽管78名受访者表示自己健康且日常生活无问题，但46人至少患有一种慢性病。在回答为何不定期去医院就诊的问题时，许多研究对象表示负责医生告知他们无需再就诊；其他人则认为自己身体健康，无需咨询医生。
一些停止随访就诊的癌症幸存者可能仍患有与癌症相关的疾病。幸存者相关和医生相关的障碍都导致癌症幸存者停止随访就诊。为确保幸存者接受适当的随访，有必要对幸存者、其家人和医务人员进行关于癌症及其治疗的晚期影响以及长期随访重要性的教育。
