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

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 (RR, 2.3; 95 percent CI 1.8-2.9), earning Conclusions. While the incidence of late effects increases over time for survivors, the likelihood of receiving survivor-focused care decreases for vulnerable populations. Key Words. Childhood cancer survivors, health insurance, health care access, survivorship, delivery of health care
The improvement in long-term survival of children with cancer to over 83 percent is one of the major success stories in oncology (Howlader et al. 2013). Consequently, there are more [...]