Klinik für Hämatologie, Universitätsklinikum Essen, Universität Duisburg-Essen, Hufelandstraße 55, 45147, Essen, Germany.
Institut für Medizinische Informatik, Biometrie und Epidemiologie, Universität Duisburg-Essen, Essen, Germany.
J Cancer Res Clin Oncol. 2023 Oct;149(13):11531-11540. doi: 10.1007/s00432-023-04984-9. Epub 2023 Jul 3.
Blood cancer survivors are at increased risk for second primary malignancies, cardiovascular diseases, and infections. Little is known about preventive care in blood cancer survivors.
Our questionnaire-based study included blood cancer patients diagnosed at the University Hospital of Essen before 2010, with a ≥ 3-year interval from the last intense treatment. One section of the retrospective study covered preventive care (cancer screening, cardiovascular screening, vaccination).
Preventive care was delivered by a general practitioner for 1100 of 1504 responding survivors (73.1%), by an oncologist for 125 (8.3%), by a general practitioner together with an oncologist for 156 (10.4%), and by other disciplines for 123 (8.2%). Cancer screening was more consistently performed by general practitioners than by oncologists. The converse was true for vaccination, with particularly high vaccination rates in allogeneic transplant recipients. Cardiovascular screening did not differ between care providers. Cancer and cardiovascular screening rates in survivors eligible for statutory prevention programs were higher than in the general population (skin cancer screening 71.1%; fecal occult blood testing 70.4%; colonoscopy 64.6%; clinical breast examination 92.1%; mammography 86.8%; cervical smear 86.0%; digital rectal examination 61.9%; blood pressure test 69.4%; urine glucose test 54.4%; blood lipid test 76.7%; information about overweight 71.0%). The Streptococcus pneumoniae vaccination rate was higher (37.0%) and the influenza vaccination rate was lower (57.0%) than in the general population.
Utilization of preventive care is high among German blood cancer survivors. To ensure widespread delivery and avoid redundancy, communication between oncologists and preventive care providers is essential.
血液癌幸存者罹患第二原发恶性肿瘤、心血管疾病和感染的风险增加。关于血液癌幸存者的预防保健措施知之甚少。
我们的基于问卷调查的研究纳入了 2010 年前在埃森大学医院诊断的血液癌患者，且这些患者上次强化治疗与研究开始时间间隔至少 3 年。该回顾性研究的一部分内容涵盖了预防保健措施（癌症筛查、心血管筛查、疫苗接种）。
1504 名有回应的幸存者中，1100 名（73.1%）接受了全科医生的预防保健服务，125 名（8.3%）接受了肿瘤医生的服务，156 名（10.4%）接受了全科医生和肿瘤医生的联合服务，123 名（8.2%）接受了其他专科医生的服务。癌症筛查的执行情况更一致，全科医生的执行率高于肿瘤医生。疫苗接种的情况则相反，异基因移植受者的接种率尤其高。不同的医疗服务提供者之间心血管筛查的差异并不明显。有资格参加法定预防计划的幸存者的癌症和心血管筛查率高于一般人群（皮肤癌筛查率为 71.1%；粪便潜血检测率为 70.4%；结肠镜检查率为 64.6%；临床乳房检查率为 92.1%；乳房 X 线摄影术率为 86.8%；宫颈涂片检查率为 86.0%；直肠指检率为 61.9%；血压检测率为 69.4%；尿糖检测率为 54.4%；血脂检测率为 76.7%；超重信息率为 71.0%）。肺炎链球菌疫苗接种率较高（37.0%），流感疫苗接种率较低（57.0%）。
德国血液癌幸存者对预防保健措施的利用率较高。为了确保广泛的实施并避免冗余，肿瘤医生和预防保健提供者之间的沟通至关重要。
