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Many adolescents, young adults do not receive cancer survivorship care
More than a third of adolescents and young adults diagnosed with cancer between 2000 and 2015 did not receive follow-up survivorship care after their primary treatment ended, according to results of a study conducted at Roswell Park Cancer Institute and scheduled for presentation at the Cancer Survivorship Symposium.
“We learned in a previous, smaller focus group study that health insurance status, communication issues with their primary oncologist and ongoing adjustment challenges long after treatment ended impacted whether [patients] got survivorship care afterward,” Lynda M. Beaupin, MD, assistant professor of oncology at Roswell Park Cancer Institute, said during a press cast. “We were interested in determining how many young adults were lost to follow-up and what we can possibly learn about certain risks we can target to have them come back.”
Beaupin and colleagues extracted data from the Roswell Park Tumor Registry of all adolescents and young adults aged 18 to 39 years diagnosed with cancer between 2000 and 2015. The study included 2,367 patients divided into two groups based on diagnosis date: between 2005 and 2009 (n = 783) and between 2010 and 2014 (n = 852). The most common cancer types included leukemia/lymphoma, melanoma, thyroid carcinoma, breast cancer and germ cell tumors.
“We wanted to primarily look at insurance status, where they were treated within the institution and what sort of cancer they had,” Beaupin said.
Across all cancer types, 37% had no clinical contact since 2015, Beaupin said.
“When we tried to look at specific disease sites where [lack of survivorship care] may be more prominent, there was no significant variation across cancer types,” Beaupin said.
Among patients diagnosed between 2010 and 2014, 33% with insurance and 39% without insurance did not have a visit in 2016. Among those diagnosed between 2005 and 2009, 47% with insurance and 46% without insurance did not have a 2016 visit.
“Regardless of cancer type or insurance status, there was no baring for predicting who was going to follow-up or who did not,” Beaupin said. “The further you are out from finishing cancer treatment, the more unlikely you are to return for a follow-up visit.” – by Melinda Stevens
Reference:
Beaupin LM, et al. Abstract 29. Presented at: Cancer Survivorship Symposium: Advancing Care and Research; Feb. 16-17, 2018; Orlando.
Disclosures: Beaupin reports a consultant/advisory role with Spectrum Pharmaceuticals. The other authors report no relevant financial disclosures.
Perspective
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The oncology field has done tremendous work showing that cancer and treatments of cancer, especially for younger people, can result in long-term health risks. There are areas where physicians can help if we intervene but, if we don’t see the patient, we are unable to do that. We also can’t advise on lifestyle factors that may be very important in modifying risks for these patients.
This study highlights an important challenge we face in getting cancer survivors to take advantage of what we know and how we can help.