Barriers and facilitators of risk-based health care for adult survivors of childhood cancer: A report from the Childhood Cancer Survivor Study
Menée aux Etats-Unis par enquête auprès d'adultes ayant survécu à un cancer pédiatrique (975 répondants), cette étude de cohorte analyse les facteurs facilitant ou entravant leur suivi médical, et souligne l'importance de leur compréhension des effets indésirables tardifs des traitements
Background : Optimal risk‐based survivor health care includes surveillance for late effects and education targeted at reducing or preventing risky health behaviors. Understanding the reasons for a lack of risk‐based follow‐up care is essential.
Methods : Adult participants from the Childhood Cancer Survivor Study were surveyed about having a cancer‐related visit in the past 2 years and the likelihood of having a cancer‐related visit in the future. Additional factors thought to be related to the primary outcomes were also assessed.
Results : Nine hundred seventy‐five survivors completed the survey. Twenty‐seven percent (95% confidence interval [CI], 24%‐30%) had a cancer‐related medical visit in the previous 2 years, and 41% (95% CI, 38%‐44%) planned to have such a visit within the next 2 years. The likelihood of having had a cancer‐related visit within the last 2 years was higher among survivors assigning greater importance to these visits (relative risk [RR], 1.2; 95% CI, 1.1‐1.3), perceiving greater susceptibility to health problems (RR, 1.2; 95% CI, 1.1‐1.3), having a moderate to life‐threatening chronic health problem related to their cancer (RR, 2.1; 95% CI, 1.7‐2.7), seeing a primary care provider for a cancer‐related problem (RR, 1.3; 95% CI, 1.0‐1.6), having a cancer treatment summary (RR, 1.3; 95% CI, 1.0‐1.6), and endorsing greater confidence in physicians' abilities to address questions and concerns (RR, 1.2; 95% CI, 1.0‐1.3).
Conclusions : Educational interventions improving awareness of treatment history and susceptibility to cancer‐related late effects and corresponding risk‐based care are likely to be beneficial for survivors of childhood cancers.
Cancer , résumé, 2018