Many Young Adult Cancer Survivors Skip Follow-Up Care
NEW YORK (Reuters Health) - Adolescent and young adult cancer survivors are at increased risk for a variety of health problems, but a large percentage of them fail to seek appropriate follow-up care, a new study finds.
"We know that young adults with cancer are at risk of long-term and late effects from treatment. However, over 30% of young adults treated for cancer no longer have continued post-treatment care,” said lead study author Dr. Lynda M. Beaupin, from Roswell Park Cancer Institute in Buffalo, New York.
She presented the study findings at a press briefing February 12 ahead of presentation February 16 at the 2018 Cancer Survivorship Symposium in Orlando, Florida, co-sponsored by the American Society of Clinical Oncology (ASCO), the American Academy of Family Physicians (AAFP) and the American College of Physicians (ACP).
The researchers studied 783 adolescent and young adult (AYA) cancer survivors diagnosed from 2005 to 2009 and 852 diagnosed from 2010 to 2014 - all treated at Roswell Park. The most common types of cancer were leukemia/lymphoma, melanoma, germ-cell tumors, and thyroid and breast cancers. The patients were diagnosed between ages 15 and 39.
“Across all cancer types, 37% of patients had no clinical contact since 2015,” Dr. Beaupin reported.
The length of time since the patient's final cancer treatment visit was the most significant factor in not scheduling a follow-up appointment. Nearly half of patients in the 2005-2009 cohort (48%) did not have a follow-up visit in 2016, compared with 33% of those in the 2010-2014 cohort.
"The further you are out from finishing cancer treatment, the more unlikely you are to return for a follow-up visit," said Dr. Beaupin.
In the 2005-2009 cohort, health insurance did not appear to play a role in determining whether patients in the earlier cohort sought follow-up care, but in the later cohort, slightly more patients without than with insurance did not schedule a follow-up appointment (39% vs. 33%).
“These patients have the potential to live a normal lifespan, and we need to educate them to become their own advocates so they may receive follow-up care on a regular basis,” Dr. Beaupin said in a statement. “We hope they continue to receive that follow-up at an established cancer center that has the facilities to assess cardiac health and provide rehabilitation if needed. There are now established survivorship programs nationwide that can provide follow-up care for those who have completed treatment.”
ASCO expert and briefing moderator Dr. Timothy Gilligan said, “Cancer and treatments for cancer, especially for younger people, can result in long-term health risks and for a number of those (risks), there are areas where we can intervene, but if we don't see the patients, then we are unable to do that.”
This study “highlights an important challenge in terms of trying to get cancer survivors to take advantage of what we know and what we can help with,” Dr. Gilligan added.
The U.S. National Institutes of Health funded the study. Dr. Beaupin has served a consulting or advisory role for Spectrum Pharmaceuticals.
Cancer Survivorship Symposium 2018.