Perceptions of future health and cancer risk in adult survivors of childhood cancer: Implications for engagement in follow‐up care

Signorelli, Christina; Wakefield, Claire E.; Fardell, Joanna E.; Brierley, Mary‐Ellen; Darlington, Anne‐Sophie; Williamson, Jane; Downie, Peter; Cohn, Richard J.

doi:10.1002/cncr.31934

Cited by 9 publications

(6 citation statements)

References 5 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Survivors who reported having a second cancer and those who were more worried or anxious about the possibility of late effects displayed higher adherence to their recommendations. Consistent with our findings, the literature suggests that greater intention to engage in, and actual engagement in, follow-up care is associated with a higher perceived risk of late effects, 79,80 perception of more severe late effects, 81 greater worry 80 and a belief that a medical recommendation might prevent a secondary cancer or recurrence. 82,83 Whilst there is some evidence to suggest that more frequent health fears may deter some survivors from undergoing recommended surveillance, 84 low to moderate anxiety related to late effects may motivate survivors' desire to adopt protective health behaviours and screening.…”

Section: Discussionsupporting

confidence: 90%

Childhood Cancer Survivors’ Adherence to Healthcare Recommendations Made Through a Distance-Delivered Survivorship Program

Alchin¹,

Signorelli²,

McLoone³

et al. 2022

JMDH

Self Cite

View full text Add to dashboard Cite

Purpose Ongoing survivorship care allows childhood cancer survivors the opportunity to address treatment-related health problems and improve their quality of life. However, many survivors do not adhere to their healthcare professionals’ recommendations and the factors supporting their adherence remain unclear. Patients and Methods Long-term childhood cancer survivors completed the “Re-engage” program, which assessed survivors’ heath needs and provided individualised recommendations for health interventions and surveillance developed by an expert multi-disciplinary team (MDT). We measured survivors’ recall of, and adherence to, their individualised healthcare recommendations at one and six months post-intervention. We conducted a series of univariate negative binomial regressions to investigate factors associated with the total number of recommendations that were correctly recalled and adhered to. Results We analysed the data of 25 childhood cancer survivors who participated in Re-engage (mean age = 31.9 years). On average, survivors were provided with 6.6 recommendations (range = 1–11). Survivors accurately recalled receiving 3.0 recommendations at one month post-intervention and 1.9 at six months. Survivors had adhered to an average of 1.3 recommendations by six-month follow-up. In total, 56% of participants reported that they did not adhere to any recommendations. By six-month follow-up, greater adherence to MDT recommendations was associated with having a history of a second cancer ( B = 1.391; 95% confidence interval [CI], 0.686 to 2.097; p < 0.001) and reporting a greater level of worry about late effects ( B = 1.381; 95% CI, 0.494 to 2.269; p = 0.002). Conclusion Survivors reported sub-optimal levels of adherence and demonstrated limited recall of their healthcare recommendations. Effective communication of recommendations and clear discussion of barriers limiting adherence, coupled with late effects education, may be critical to ensure that survivors engage with their recommendations, to improve their quality of life and health outcomes. Trial Registration Number ACTRN12618000194268.

show abstract

Section: Discussionsupporting

confidence: 90%

Childhood Cancer Survivors’ Adherence to Healthcare Recommendations Made Through a Distance-Delivered Survivorship Program

Alchin¹,

Signorelli²,

McLoone³

et al. 2022

JMDH

Self Cite

View full text Add to dashboard Cite

show abstract

“…Complementing our findings, other studies have found that survivors of childhood cancer remain at increased risk of cancer many decades after their initial diagnosis, showing the importance of ongoing surveillance. However, a recent Australian survey of long term survivors of childhood cancer found that more than 60% believed they were not at greater risk of new neoplasms than other people, which suggests that educating people about this topic is difficult.…”

Section: Discussionmentioning

confidence: 99%

Second primary cancers in people who had cancer as children: an Australian Childhood Cancer Registry population‐based study

Youlden

Baade

Green

et al. 2019

Medical Journal of Australia

View full text Add to dashboard Cite

Objective To investigate the incidence of second primary cancers in people diagnosed with cancer during childhood. Design, setting Retrospective, population‐based study; analysis of Australian Childhood Cancer Registry data. Participants People alive at least two months after being diagnosed before the age of 15 years with a primary cancer, 1983–2013, followed until 31 December 2015 (2–33 years' follow‐up). Main outcome measures Risks of second primary cancer compared with the general population, expressed as standardised incidence ratios (SIRs). Results Among 18 230 people diagnosed with cancer during childhood, 388 (2%) were later diagnosed with second primary cancers; the estimated 30‐year cumulative incidence of second cancers was 4.4% (95% CI, 3.8–5.0%). The risk of a new primary cancer was five times as high as for the general population (SIR, 5.13; 95% CI, 4.65–5.67). Relative risk of a second primary cancer was greatest for people who had childhood rhabdomyosarcoma (SIR, 19.9; 95% CI, 14.4–27.6). Relative risk was particularly high for children who had undergone both chemotherapy and radiotherapy (SIR, 9.80; 95% CI, 8.35–11.5). Relative risk peaked during the 5 years following the first diagnosis (2 to less than 5 years: SIR, 10.3; 95% CI, 8.20–13.0), but was still significant at 20–33 years (SIR, 2.58; 95% CI, 2.02–3.30). The most frequent second primary cancers were thyroid carcinomas (65 of 388, 17%) and acute myeloid leukaemias (57, 15%). Conclusions Survivors of childhood cancer remain at increased risk of a second primary cancer well into adulthood. As the late effects of cancer treatment probably contribute to this risk, treatments need to be refined and their toxicity reduced, without reducing their benefit for survival.

show abstract

“…Collectively, these findings suggest that YA‐CCS who are enfranchised within the healthcare system either through self‐management, survivorship informational resources, or due to ongoing health needs, and from higher risk groups, may be more likely to receive counseling on and subsequently engage in recommended skin care screening. As YA‐CCS drop out of cancer‐focused survivorship care at high rates as age and time from diagnosis increases, 26,40,41 our findings underscore the need to retain this population in healthcare to receive needed preventive care such as skin examination.…”

Section: Discussionmentioning

confidence: 76%

Prevalence and correlates of skin examination among ethnically diverse young adult survivors of childhood cancer

Miller

Wojcik

et al. 2022

Cancer Medicine

View full text Add to dashboard Cite

Background: Skin cancer is the most common secondary malignancy among young adult childhood cancer survivors (YA-CCS). Skin examination to detect skin cancer early (including melanoma as well as basal or squamous cell skin cancers), both physician-based (PSE) and self-skin exam (SSE), is recommended, particularly for radiotherapy-exposed YA-CCS who are at high risk of developing skin cancer.Methods: Awareness and prevalence of skin examination and demographic, clinical, and healthcare correlates were examined in a population-based sample of YA-CCS with diverse cancer types excluding melanoma. Descriptive frequencies and logistic regression models were conducted using sample weights to correct for non-response bias with PSE, SSE and adherence to both as outcomes. Results:The sample comprised 1064 participants with 53% Latino. Eight percent of participants were aware of the need for skin examination; 9% reported receipt of PSE within past 2 years; 35% reported regular SSE; and 6% were adherent to both. Among the radiotherapy-treated, 10% were aware of the need for skin examination, 10% reported recent PSE; 38% reported regular SSE; and 8% How to cite this article: Miller KA, Li AA, Wojcik KY, et al. Prevalence and correlates of skin examination among ethnically diverse young adult survivors of childhood cancer.

show abstract

Perceptions of future health and cancer risk in adult survivors of childhood cancer: Implications for engagement in follow‐up care

Cited by 9 publications

References 5 publications

Childhood Cancer Survivors’ Adherence to Healthcare Recommendations Made Through a Distance-Delivered Survivorship Program

Childhood Cancer Survivors’ Adherence to Healthcare Recommendations Made Through a Distance-Delivered Survivorship Program

Second primary cancers in people who had cancer as children: an Australian Childhood Cancer Registry population‐based study

Prevalence and correlates of skin examination among ethnically diverse young adult survivors of childhood cancer

Contact Info

Product

Resources

About