title: Medical visits of childhood cancer survivors in Japan: a cross-sectional survey.
abstract: BACKGROUND
  Although more children with cancer continue to be cured, these survivors experience various late effects. Details of the medical visit behaviors of childhood cancer survivors (CCS) in adulthood remain to be elucidated.
  
  
  METHODS
  In order to examine medical visits in the past and future of CCS, we performed a cross-sectional survey with self-rating questionnaires on medical visits of CCS compared with control groups (their siblings and the general population).
  
  
  RESULTS
  Questionnaires were completed by 185 CCS, 72 of their siblings and 1000 subjects from the general population and the results were analyzed. Mean ages at this survey and the duration after therapy completions of CCS were 23 and 12 years, respectively. We found that the previous treatment hospitals (where CCS were treated for their cancer) were the most commonly visited medical facilities for the CCS group (74% for female patients and 64% for male patients) and more than half of the CCS preferred to continue visiting the previous treatment hospital with enough satisfaction in Japan. The multivariate analysis showed that female sex and relapse were significantly associated with the past visits to the previous treatment hospital and that the CCS with brain tumors or bone/soft tissue sarcomas and CCS with any late effects tended to continue the relationships with the hospital. In addition female sex was also significantly associated with desired future visits to the previous treatment hospital. On the other hand, the married CCS tended to be disinclined to visit the hospital it in the future.
  
  
  CONCLUSIONS
  In order to optimize risk-based care and promote health for CCS after adulthood, we should discuss the medical transition with CCS and their parents.
authors.affiliation: Department of Pediatrics, St. Luke's International Hospital, Tokyo, Japan. yaishida@luke.or.jp
authors.forename: Yasushi
authors.initials: Y
authors.lastname: Ishida
authors.forename: Shuichi
authors.initials: S
authors.lastname: Ozono
authors.forename: Naoko
authors.initials: N
authors.lastname: Maeda
authors.forename: Jun
authors.initials: J
authors.lastname: Okamura
authors.forename: Keiko
authors.initials: K
authors.lastname: Asami
authors.forename: Tsuyako
authors.initials: T
authors.lastname: Iwai
authors.forename: Kiyoko
authors.initials: K
authors.lastname: Kamibeppu
authors.forename: Naoko
authors.initials: N
authors.lastname: Sakamoto
authors.forename: Naoko
authors.initials: N
authors.lastname: Kakee
authors.forename: Keizo
authors.initials: K
authors.lastname: Horibe
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D015994:Incidence; D007564:Japan / Q000453:epidemiology; D008297:Male; D009369:Neoplasms / Q000453:epidemiology*; D009819:Office Visits / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D011795:Surveys and Questionnaires; D017741:Survivors / Q000706:statistics & numerical data*; D055815:Young Adult