Highest-risk childhood cancer survivors don't follow recommended screenings
Highest-risk childhood cancer survivors don't follow recommended screenings
Most survivors of childhood cancers at highest risk for a second neoplasm in adulthood didn't follow recommended screening intervals, a study found.
To examine adherence to population cancer screening guidelines, researchers conducted a retrospective cohort study among 26 centers to find long-term survivors of childhood cancer diagnosed between 1970 and 1986.
Researchers identified 4,329 male and 4,018 female survivors of childhood cancer and surveyed them about mammography, Pap smears, colonoscopy or skin examinations. They compared screening rates to U.S. Preventive Services Task Force guidelines for survivors at average risk for breast or cervical cancer or the Children's Oncology Group guidelines, which recommend more aggressive surveillance and screening for survivors at high risk for breast, colorectal or skin cancer. The study results appear in the Oct. 5 Annals of Internal Medicine.
Researchers found that while average-risk female survivors were somewhat compliant with cervical and breast cancer guidelines for screening, surveillance was alarmingly low in survivors at the highest risk for colon, breast or skin cancer.
In average-risk female survivors, 2,743 of 3,392 (80.9%) reported having a Pap smear within the recommended period, and 140 of 209 (67.0%) reported mammography within the recommended period. In high-risk survivors, rates of recommended mammography among women were only 241 of 522 (46.2%) and the rates of colonoscopy and complete skin examinations among both sexes were 91 of 794 (11.5%) and 1,290 of 4,850 (26.6%), respectively. Reported screening rates were worst for colorectal cancer (11.5%), followed by skin cancer (26.6%) and breast cancer (46.2%).
Survivors of childhood cancer and their physicians must be better educated about the potential benefits of enhanced cancer screening, the authors wrote: "Interventions to improve adherence to cancer surveillance should be directed at the primary care physicians who care for most long-term survivors of childhood cancer, as well as to the survivors themselves."
Physician recommendation promotes compliance, the authors wrote, but many primary care physicians are probably unaware of the surveillance guidelines for these high-risk patients. ACP Internist addressed how primary care physicians can treat adult survivors of cancer, as well as a host of other childhood diseases, in the recent article "History is key after childhood disease."