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Pathways of care for adolescent patients with cancer in France from 2006 to 2007
Author(s) -
Desandes Emmanuel,
Bonnay Stéphanie,
Berger Claire,
Brugieres Laurence,
Demeocq François,
Laurence Valérie,
Sommelet Danièle,
Tron Isabelle,
Clavel Jacqueline,
Lacour Brigitte
Publication year - 2012
Publication title -
pediatric blood and cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.116
H-Index - 105
eISSN - 1545-5017
pISSN - 1545-5009
DOI - 10.1002/pbc.24032
Subject(s) - medicine , context (archaeology) , cancer , quartile , population , pediatric cancer , randomized controlled trial , pediatrics , family medicine , blood cancer , environmental health , paleontology , confidence interval , biology
Background In France, as in other countries, there is a need for a population‐based view of access to care and modalities of treatment for adolescents with cancer. Procedure Using a population‐based registration, we report pathways of care for 15–19‐year‐old patients, diagnosed with cancer in 2006 and 2007, living in six French regions, accounting for 41% of the French population. Results The median times (inter‐quartile range) for diagnosis and treatment of the 594 included adolescents were 8 weeks (3–17) and 3 days (0–16), respectively. First physicians met by the patients were mostly general practitioners (59%). Seventeen percent of patients were firstly seen on emergency wards. Most of the patients (82%) were treated in an adult environment. Management decisions were taken within the context of a multi‐disciplinary team (MDT) in 54% of cases. Twenty‐seven percent of patients were included in randomized or non‐randomized clinical studies: percentage depended on the tumor type and on the number of on‐going trials at the study period. Fifteen percent of patients were included in pediatric studies, 7% in adult studies, and 5% in studies including both adults and children. Conclusions The pathways of care for French adolescent patients with cancer are heterogeneous. Our results reveal differences in MDT meetings according to tumor types and a lack of effective collaboration between pediatric and adult wards. Efforts must be made to develop cancer networks to ensure that adolescents receive the optimal care in a suitable environment. Pediatr Blood Cancer 2012; 58: 924–929. © 2011 Wiley Periodicals, Inc.