title: Predictors of Suboptimal Follow-up in Pediatric Cancer Survivors.
abstract: Attendance to follow-up care after completion of cancer treatment is an understudied area. We examined demographic, clinical, and socioeconomic predictors of follow-up by pediatric cancer patients at a large center in 442 newly diagnosed patients using multivariable logistic regression analyses. Patients who did not return to clinic for at least 1000 days were considered lost to follow-up. Two hundred forty-two (54.8%) patients were lost. In multivariable analyses, the following variables were independent predictors of being lost to follow-up: treatment with surgery alone (odds ratio [OR]=6.7; 95% confidence interval [CI], 3.1-14.9), older age at diagnosis (reference, 0 to 4; ages, 5 to 9: OR=1.8, 95% CI, 1.1-3; ages, 10 to 14: OR=3.3; CI, 1.8-6.1; and ages, 15 and above: OR=4.8; CI, 2.1-11.7), lack of history of stem cell transplantation (OR=2, 95% CI, 1.04-3.7) and lack of insurance (OR=3.4; CI, 1.2-9.2). Hispanic patients had the best follow-up rates (53.7%) compared to whites and blacks (P=0.03). Attendance to long-term follow-up care is suboptimal in childhood cancer survivors. Predictors that were associated with nonattendance can be used to design targeted interventions to improve follow-up care for survivors of pediatric cancer.
authors.affiliation: *Section of Emergency Medicine, Children's Hospital of Colorado, Aurora, CO †Department of Pediatrics, Section of Psychology ‡Department of Pediatrics, Section of Hematology-Oncology, Texas Children's Cancer Center §Department of Medicine, Section of General Medicine, Baylor College of Medicine, Houston ∥Department of Psychiatry, Pauline Allen Gill Center for Cancer and Blood Disorders, Dallas, TX.
authors.forename: Leana
authors.initials: L
authors.lastname: May
authors.forename: David D
authors.initials: DD
authors.lastname: Schwartz
authors.forename: Ernest
authors.initials: E
authors.lastname: Frugé
authors.forename: Larry
authors.initials: L
authors.lastname: Laufman
authors.forename: Suzanne
authors.initials: S
authors.lastname: Holm
authors.forename: Kala
authors.initials: K
authors.lastname: Kamdar
authors.forename: Lynnette
authors.initials: L
authors.lastname: Harris
authors.forename: Julienne
authors.initials: J
authors.lastname: Brackett
authors.forename: Sule
authors.initials: S
authors.lastname: Unal
authors.forename: Gulsah
authors.initials: G
authors.lastname: Tanyildiz
authors.forename: Rosalind
authors.initials: R
authors.lastname: Bryant
authors.forename: Hilary
authors.initials: H
authors.lastname: Suzawa
authors.forename: Zoann
authors.initials: Z
authors.lastname: Dreyer
authors.forename: M Fatih
authors.initials: MF
authors.lastname: Okcu
mesh_terms: D000293:Adolescent; D000359:Aftercare / Q000592:standards*; D002648:Child; D002675:Child, Preschool; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D015999:Multivariate Analysis; D009369:Neoplasms / Q000628:therapy*; D010342:Patient Acceptance of Health Care / Q000208:ethnology / Q000706:statistics & numerical data*; D010349:Patient Compliance / Q000208:ethnology / Q000706:statistics & numerical data; D012307:Risk Factors; D017741:Survivors