May Leana, Schwartz David D, Frugé Ernest, Laufman Larry, Holm Suzanne, Kamdar Kala, Harris Lynnette, Brackett Julienne, Unal Sule, Tanyildiz Gulsah, Bryant Rosalind, Suzawa Hilary, Dreyer Zoann, Okcu M Fatih
*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.
J Pediatr Hematol Oncol. 2017 Apr;39(3):e143-e149. doi: 10.1097/MPH.0000000000000723.
Attendance to follow-up care after completion of cancer treatment is an understudied area. We examined demographic, clinical, and socioeconomic predictors of follow-up by pediatric cancer patients at a large center in 442 newly diagnosed patients using multivariable logistic regression analyses. Patients who did not return to clinic for at least 1000 days were considered lost to follow-up. Two hundred forty-two (54.8%) patients were lost. In multivariable analyses, the following variables were independent predictors of being lost to follow-up: treatment with surgery alone (odds ratio [OR]=6.7; 95% confidence interval [CI], 3.1-14.9), older age at diagnosis (reference, 0 to 4; ages, 5 to 9: OR=1.8, 95% CI, 1.1-3; ages, 10 to 14: OR=3.3; CI, 1.8-6.1; and ages, 15 and above: OR=4.8; CI, 2.1-11.7), lack of history of stem cell transplantation (OR=2, 95% CI, 1.04-3.7) and lack of insurance (OR=3.4; CI, 1.2-9.2). Hispanic patients had the best follow-up rates (53.7%) compared to whites and blacks (P=0.03). Attendance to long-term follow-up care is suboptimal in childhood cancer survivors. Predictors that were associated with nonattendance can be used to design targeted interventions to improve follow-up care for survivors of pediatric cancer.
