title: Patterns of physician follow-up among young cancer survivors: report of the Childhood, Adolescent, and Young Adult Cancer Survivors (CAYACS) research program.
abstract: OBJECTIVE
  To describe the frequency and pattern of physician visits in 1998 to 2000 among childhood and adolescent cancer survivors in British Columbia (BC), to compare their use of physician services with use in the general population, and to examine the effects of clinical and sociodemographic factors on care.
  
  
  METHODS
  Retrospective, observational, population-based cohort study, with a comparison group. Cohort records from population registries were linked to physician claim data and oncology visit records for 1998 to 2000.
  
  
  METHODS
  Outpatient physician care in BC.
  
  
  METHODS
  All (N = 1157) survivors of cancer diagnosed before age 20 years in BC between 1970 and 1992 who survived at least 5 years after diagnosis, and an age-sex frequency-matched population sample of 11 570 individuals.
  
  
  METHODS
  Probability of a physician visit and frequency of physician visits.
  
  
  RESULTS
  Approximately 97% of survivors saw at least 1 physician in the 3-year period, compared with 50% of the general population sample. The probability of a GP visit was 96% higher (adjusted 95% confidence interval [CI] 1.8 to 2.1), and the likelihood of a specialist visit was 157% higher (adjusted 95% CI 2.4 to 2.8) than for the general population. Survivors were more than twice as likely to see GPs at least 10 times (adjusted relative risk 2.23, 95% CI 2.0 to 2.4) and had 49% more visits than the general population. Cancer diagnosis and treatment affected visit patterns, but socioeconomic status and rural residency did not significantly affect the probability of a visit.
  
  
  CONCLUSIONS
  Demand for physician care among childhood and adolescent cancer survivors is considerably greater than for the general population, and this need persists many years after diagnosis. Physicians need information on the unique health care requirements of this patient group in order to provide appropriate care.
authors.affiliation: Cancer Control Research Program, British Columbia Cancer Agency, Vancouver, BC. mmcbride@bccrc.ca
authors.forename: Mary L
authors.initials: ML
authors.lastname: McBride
authors.forename: Maria F
authors.initials: MF
authors.lastname: Lorenzi
authors.forename: Jacqueline
authors.initials: J
authors.lastname: Page
authors.forename: Anne-Marie
authors.initials: AM
authors.lastname: Broemeling
authors.forename: John J
authors.initials: JJ
authors.lastname: Spinelli
authors.forename: Karen
authors.initials: K
authors.lastname: Goddard
authors.forename: Sheila
authors.initials: S
authors.lastname: Pritchard
authors.forename: Paul
authors.initials: P
authors.lastname: Rogers
authors.forename: Sam
authors.initials: S
authors.lastname: Sheps
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D001955:British Columbia; D002648:Child; D002675:Child, Preschool; D005260:Female; D058005:General Practitioners / Q000706:statistics & numerical data; D006301:Health Services Needs and Demand; D006801:Humans; D007223:Infant; D008297:Male; D009369:Neoplasms / Q000175:diagnosis / Q000628:therapy*; D009819:Office Visits / Q000706:statistics & numerical data*; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data*; D016012:Poisson Distribution; D012189:Retrospective Studies; D012737:Sex Factors; D013038:Specialization / Q000706:statistics & numerical data; D017741:Survivors / Q000706:statistics & numerical data*; D055815:Young Adult