Ishida Yasushi, Ozono Shuichi, Maeda Naoko, Okamura Jun, Asami Keiko, Iwai Tsuyako, Kamibeppu Kiyoko, Sakamoto Naoko, Kakee Naoko, Horibe Keizo
Department of Pediatrics, St. Luke's International Hospital, Tokyo, Japan.
Pediatr Int. 2011 Jun;53(3):291-9. doi: 10.1111/j.1442-200X.2010.03293.x.
Although more children with cancer continue to be cured, these survivors experience various late effects. Details of the medical visit behaviors of childhood cancer survivors (CCS) in adulthood remain to be elucidated.
In order to examine medical visits in the past and future of CCS, we performed a cross-sectional survey with self-rating questionnaires on medical visits of CCS compared with control groups (their siblings and the general population).
Questionnaires were completed by 185 CCS, 72 of their siblings and 1000 subjects from the general population and the results were analyzed. Mean ages at this survey and the duration after therapy completions of CCS were 23 and 12 years, respectively. We found that the previous treatment hospitals (where CCS were treated for their cancer) were the most commonly visited medical facilities for the CCS group (74% for female patients and 64% for male patients) and more than half of the CCS preferred to continue visiting the previous treatment hospital with enough satisfaction in Japan. The multivariate analysis showed that female sex and relapse were significantly associated with the past visits to the previous treatment hospital and that the CCS with brain tumors or bone/soft tissue sarcomas and CCS with any late effects tended to continue the relationships with the hospital. In addition female sex was also significantly associated with desired future visits to the previous treatment hospital. On the other hand, the married CCS tended to be disinclined to visit the hospital it in the future.
In order to optimize risk-based care and promote health for CCS after adulthood, we should discuss the medical transition with CCS and their parents.
尽管越来越多的癌症患儿得以治愈，但这些幸存者会经历各种后期影响。儿童癌症幸存者（CCS）成年后的就医行为细节仍有待阐明。
为了调查CCS过去和未来的就医情况，我们进行了一项横断面调查，采用自评问卷对CCS的就医情况与对照组（他们的兄弟姐妹和普通人群）进行比较。
185名CCS、72名他们的兄弟姐妹和1000名普通人群完成了问卷调查，并对结果进行了分析。本次调查时CCS的平均年龄和治疗结束后的时长分别为23岁和12年。我们发现，之前的治疗医院（CCS接受癌症治疗的医院）是CCS组最常就诊的医疗机构（女性患者为74%，男性患者为64%），并且在日本，超过一半的CCS对继续就诊于之前的治疗医院感到足够满意。多变量分析显示，女性和复发与过去就诊于之前的治疗医院显著相关，患有脑肿瘤或骨/软组织肉瘤的CCS以及有任何后期影响的CCS倾向于继续与该医院保持联系。此外，女性也与未来希望就诊于之前的治疗医院显著相关。另一方面，已婚的CCS未来往往不太愿意去该医院就诊。
为了优化基于风险的护理并促进CCS成年后的健康，我们应该与CCS及其父母讨论医疗过渡问题。
