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- Page navigation anchor for Follow-up Care for Cancer Survivors: Developing the Evidence BaseFollow-up Care for Cancer Survivors: Developing the Evidence BaseShow More
There are an estimated 9.6 million cancer survivors in the United States today. Current figures indicate 62% of adults and 79% of children diagnosed today will survive beyond five years. However, few current cancer therapies are benign, and widely used cancer treatments are known to carry substantial risk of adverse long-term or late treatment related effects. Given the median age at diagnosis (67-68 years) and length o...
Competing Interests: None declared. - Page navigation anchor for The Next Action StepsThe Next Action StepsShow More
Dr. Oeffinger’s excellent analysis of health care utilization by the CCSS cohort provides an important baseline to understanding the need to prepare survivors and family practice physicians to manage and control late effects of treatment for childhood cancer. The next step is, of course, determining how to establish and pay for systems of follow-up care, which are flexible and appropriate to the needs of individual surv...
Competing Interests: None declared. - Page navigation anchor for Health Care of Young Adult Survivors of Childhood Cancer: A Report from the Childhood Cancer Survivor StudyHealth Care of Young Adult Survivors of Childhood Cancer: A Report from the Childhood Cancer Survivor StudyShow More
This excellent paper establishes baseline information on the use of appropriate health care utilisation in young adults survivors of childhood cancer separating cancer related visits from general medical contact. The majority of the survivors were treated in the 1970.s when physicians were struggling to improve the cure rate and hence less concerned and unaware of the impact of long term sequelae. We must therefore be...
Competing Interests: None declared. - Page navigation anchor for What is the correlation between increasing health concerns yet decreasing medical visits among long-term survivors of childhood cancers?What is the correlation between increasing health concerns yet decreasing medical visits among long-term survivors of childhood cancers?Show More
In her comment ("Are post-traumatic stress and health care utilization related?"), Sophia K. Smith raises a noteworthy question. Her suggestion that "cancer-related post-traumatic stress has a negative impact on risk-based health care utilization in survivor populations" is a distinct possibility. This is a topic which comes up on the LTS online discussion group referred to in past comments. Dr. Greenberg ("Assuring ca...
Competing Interests: None declared. - Page navigation anchor for Are post-traumatic stress and health care utilization related?Are post-traumatic stress and health care utilization related?Show More
Dr. Kevin Oeffinger and his colleagues provide a much-needed examination of the current use of health care by childhood cancer survivors. Socio-demographic and cancer-related factors that were associated with lower levels of usage include: 1) lack of health insurance; 2) lack of concern for future health; 3) male sex; and 4) age 30 years or older (in comparison to those 18 to 29 years). Cancer anxiety was measured but w...
Competing Interests: None declared. - Page navigation anchor for A five point plan to help survivorsA five point plan to help survivorsShow More
I am a 32-year survivor of Wilms' tumor, which metastasized to my lung. I am also a member of the Long-Term Survivors (LTS) online discussion list mentioned by Linda Goettina.
I was very pleased to read the article by Kevin Oeffinger, et al, Health Care of Young Adult Survivors of Childhood Cancer: A Report from the Childhood Cancer Survivor Study. This article notes, “there has not been a national effort...
Competing Interests: None declared. - Page navigation anchor for Assuring care for childhood cancer survivorsAssuring care for childhood cancer survivorsShow More
This paper is timely indeed – the consensus amongst health care providers, parents and survivors that gave rise to the report published by the National Cancer Board1 attests to that. The long term outcomes in cancer survivors reflect an interplay of the type and extent of treatment delivered, hereditable characteristics that may modify the impact of that treatment, and environmental exposures and modifiers, both...
Competing Interests: None declared. - Page navigation anchor for Long-Term Survivors of Childhood Cancers Need HelpLong-Term Survivors of Childhood Cancers Need HelpShow More
I am a 47-year survivor of Wilms' tumor, treated at age 11 months in 1956, and a member of the Long-Term Survivors (LTS) online discussion list mentioned by Linda Goettina.
Dr. Kevin Oeffinger and his colleagues study of and subsequent article on "Health Care of Young Adults of Childhood Cancer" is a huge step forward dealing with issues for childhood cancer survivors and it brings these concerns to the forefron...
Competing Interests: None declared. - Page navigation anchor for Needed: A Study of the Health Care of Older Adult Survivors of Childhood CancerNeeded: A Study of the Health Care of Older Adult Survivors of Childhood CancerShow More
I am a 50-year survivor of Wilms’ tumor and a member of the long-term survivors (LTS) internet discussion group mentioned by Linda Goettina (“Further Thoughts on Follow-up Care”). List members have often discussed the intense silence in the medical community on the long-term health care of all long-term cancer survivors. "Health Care of Young Adult Survivors of Childhood Cancer" is a beginning, and LTS welcome every effo...
Competing Interests: None declared. - Page navigation anchor for Systemic and psychological barriers to survivor care: Comment on Oeffinger et al.Systemic and psychological barriers to survivor care: Comment on Oeffinger et al.Show More
Oeffinger et al.(1) have quantified the familiar difficulties faced by childhood cancer survivors entering the adult health system. Even in this cohort treated at major cancer centers and motivated to participate in a demanding study, many are not adequately followed for their unique vulnerabilities. Examples of high-risk patients almost certainly not monitored for potentially life threatening late-effects are alarmin...
Competing Interests: None declared. - Page navigation anchor for Childhood Cancer Survivors and long-term follow-up careChildhood Cancer Survivors and long-term follow-up careShow More
Oeffinger and colleagues provide a cogent and empirically based rationale for long-term health care and surveillance for survivors of childhood cancer. They emphasize the need to (1) educate survivors about long-term effects and health risks related to treatment, (2) enhance the transition of care to primary care providers, and (3) foster on-going communication between childhood cancer survivors, the cancer centers wher...
Competing Interests: None declared. - Page navigation anchor for additional comments on the insurance questionadditional comments on the insurance questionShow More
Dr. Mahoney writes, “It is likely that a portion of those survivors not reporting any medical care lack health insurance since respondents were typically in their 20’s or 30’s and treatments may have interrupted educational/vocational training. Oeffinger et al.(5) did not provide comparisons of levels of medical contact from the general population, nor did they report whether these survivors were more or less likely to r...
Competing Interests: None declared. - Page navigation anchor for Health care of adult survivors of childhood cancerHealth care of adult survivors of childhood cancerShow More
The report by Oeffinger and colleagues provides us with important and rather sobering data on the health care practices of adult survivors of childhood cancer. The results of this large cohort study, while not entirely unexpected, underscore the magnitude of the problem: How do we provide optimum health care that is both informed and accessible to this vulnerable population? Of great concern is the fact that the health p...
Competing Interests: None declared. - Page navigation anchor for Clinical Follow-Up of Childhood Cancer SurvivorsClinical Follow-Up of Childhood Cancer SurvivorsShow More
The latest report from the Childhood Cancer Survivor Study written by Oeffinger et al indicates that about 83%, 49% and 31% of survivors aged 18 -19 years reported a general physical examination, a cancer related visit to a physician’s office or a visit to a cancer centre, respectively. In contrast, the percentages of survivors aged 35-48 years reporting these types of visits declined to 67%, 38% and 17%, respectively. Th...
Competing Interests: None declared. - Page navigation anchor for Healthcare Utilization by Childhood Cancer Survivors - where do we go next?Healthcare Utilization by Childhood Cancer Survivors - where do we go next?Show More
The authors determined the healthcare utilization reported by 9,434 young adult survivors of childhood cancer, and examined factors associated with limited medical care. Outpatient medical care within the last two years was defined as one of the following four: i) general contact with the health care system, general physical examination, cancer-related medical visit, and medical visit at a cancer center. Factors associate...
Competing Interests: None declared. - Page navigation anchor for Young Adults Cured of Childhood Cancer: What is the "Quality" of the Cure?Young Adults Cured of Childhood Cancer: What is the "Quality" of the Cure?Show More
In this article Dr. Kevin Oeffinger and his colleagues, reporting for the Childhood Cancer Survivor Study (CCSS), describe patterns of ongoing health care received by young adult survivors of childhood cancer. The CCSS cohort they studied is by far the largest in the world of individuals diagnosed with cancer during childhood and then followed for several decades. Fortunately, over three-quarters of children with cancer...
Competing Interests: None declared. - Page navigation anchor for Providing Comprehensive Care to Adult Survivors of Childhood Cancer.Providing Comprehensive Care to Adult Survivors of Childhood Cancer.Show More
Oeffinger K, Mertens A, Hudson M, et.al.: Heatlh Care of Young Adult Survivors of Childhood Cancer: A Report from the Childhood Cancer Survivor Study.
Commentary Wendy Hobbie
In the future, one of the great challenges for pediatric oncology will be to prepare the adult health care system for the specialized needs of childhood cancer survivors. Many survivors currently lead healthy lives, however, there...
Competing Interests: None declared. - Page navigation anchor for Important Discussion Regarding Long-term follow-up careImportant Discussion Regarding Long-term follow-up careShow More
"Health Care of Young Adult Survivors of Childhood Cancer: A Report from the Childhood Cancer Survivor Study" provides a wonderful look at a growing problem facing the American health care system.
As a young adult cancer survivor I have experienced first hand the barriers associated with receiving coordinated quality long-term survivorship care.
In my role as Director of Survivorship at the Lance Armst...
Competing Interests: None declared. - Page navigation anchor for Recognizing the medical needs of childhood cancer survivorsRecognizing the medical needs of childhood cancer survivorsShow More
Survivors of childhood cancers are at increased risk of developing a variety of late medical complications as a result of prior cancer therapy (1-3) and health status is also negatively impacted.(4) The paper by Oeffinger & colleagues indicates that although 87% of childhood cancer survivors reported some contact with the medical care system during the preceding two years, reports of a general physical examination, a...
Competing Interests: None declared. - Page navigation anchor for Further Thoughts on Follow-up CareFurther Thoughts on Follow-up CareShow More
It’s a pleasure to read, “Health Care of Young Adult Survivors of Childhood Cancer.” It identifies some of the problems and dilemmas of good care for survivors of childhood/adolescent. However, it is limited in scope by the study design––self-reporting questionnaire––and may miss some significant factors worthy of further investigation.
I work (via an Internet discussion group) with a group of long-term survivor...
Competing Interests: None declared.