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New health conditions identified at a regional childhood cancer survivor clinic visit
Author(s) -
Staba Hogan MaryJane,
Ma Xiaomei,
KadanLottick Nina S.
Publication year - 2013
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.24360
Subject(s) - medicine , survivorship curve , specialty , cancer , odds ratio , pediatrics , confidence interval , cancer survivor , late effect , radiation therapy , cancer survivorship , physical therapy , family medicine
Background Specialty childhood cancer survivorship clinics have been established to screen for potential treatment‐related effects. Given the limited empirical data regarding the merit of survivorship clinics, we assessed the frequencies of newly identified, therapy‐related effects in survivors who attended Health, Education, Research, Outcomes for Survivors (HEROS) clinic at Yale during 2003–2009. Procedure A total of 213 survivors in remission, who were diagnosed with cancer at an age ≤21 years and were ≥3 years after cancer diagnosis, underwent screening based on cancer treatment exposures according to the children's oncology group long‐term follow‐up guidelines. The frequencies and associated factors of newly identified health conditions were determined. Odds ratios (OR) and their 95% confidence intervals were estimated using multivariate regression models with stepwise selection. Results Prior to the HEROS clinic visit, 49% of patients had at least one previously known late complication of therapy. After the visit, a total of 98 new health conditions were identified in 73 patients (34%). Newly identified complications in screened patients included pulmonary dysfunction (23%), endocrinopathy (19%), osteoporosis (17%), dyslipidemia (8%), neurologic impairment (4%), cardiovascular deficit (3%) and subsequent cancer (3%). Age at cancer diagnosis (OR = 1.06 [1.00–1.11]), chest irradiation (OR = 2.92 [1.58–5.40]), and history of ≥1 other treatment‐related complication(s) (OR = 2.20 [1.18–4.07]) were associated with a higher likelihood of having new conditions identified. Conclusion Risk‐based screening at a specialty childhood cancer survivor clinic detected a substantial number of previously unrecognized, treatment‐related health complications in a group of survivors already receiving regular medical care elsewhere. Pediatr Blood Cancer 2013; 60: 682–687. © 2012 Wiley Periodicals, Inc.