Volume 50 | Number 4 | August 2015

Abstract List

Identifying Predictors of Longitudinal Decline in the Level of Medical Care Received by Adult Survivors of Childhood Cancer: A Report from the Childhood Cancer Survivor Study

Jacqueline Casillas M.D., M.S.H.S., Kevin C. Oeffinger M.D., Melissa M. Hudson M.D., Mark L. Greenberg M.B., Ch.B., F.R.C.P.C., F.A.A.P., Mark W. Yeazel M.D., M.P.H., Kirsten K. Ness P.T., Ph.D., Tara O. Henderson M.D., Leslie L. Robison Ph.D., Gregory T. Armstrong M.D., Qi Liu M.S., Wendy Leisenring Sc.D., Yutaka Yasui Ph.D., Paul C. Nathan M.D., M.Sc.


Objectives

Characterize longitudinal changes in the use of medical care in adult survivors of childhood cancer.


Data Sources

The Childhood Cancer Survivor Study, a retrospective cohort study of 5+ year survivors of childhood cancer.


Study Design

Medical care was assessed at entry into the cohort (baseline) and at most recent questionnaire completion. Care at each time point was classified as no care, general care, or survivor‐focused care.


Data Collection

There were 6,176 eligible survivors. Multivariable models evaluated risk factors for reporting survivor‐focused care or general medical care at baseline and no care at follow‐up; and survivor‐focused care at baseline and general care at follow‐up.


Principal Findings

Males (, 2.3; 95 percent 1.8–2.9), earning <$20,000/year (, 1.6; 95 percent 1.2–2.3) or ≤high school education (, 2.5; 95 percent 1.6–3.8 and 2.0; 95 percent 1.5–2.7 for


Conclusions

While the incidence of late effects increases over time for survivors, the likelihood of receiving survivor‐focused care decreases for vulnerable populations.