Predictors of Suboptimal Follow-up in Pediatric Cancer Survivors

J Pediatr Hematol Oncol. 2017 Apr;39(3):e143-e149. doi: 10.1097/MPH.0000000000000723.

Abstract

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.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Adolescent
  • Aftercare / standards*
  • Child
  • Child, Preschool
  • Humans
  • Infant
  • Infant, Newborn
  • Multivariate Analysis
  • Neoplasms / therapy*
  • Patient Acceptance of Health Care / ethnology
  • Patient Acceptance of Health Care / statistics & numerical data*
  • Patient Compliance / ethnology
  • Patient Compliance / statistics & numerical data
  • Risk Factors
  • Survivors