Details

Autor(en) / Beteiligte

• Signorelli, Christina
• Wakefield, Claire E
• Fardell, Joanna E
• Wallace, W. Hamish B
• Robertson, Eden G
• McLoone, Jordana K
• Cohn, Richard J

Titel

The impact of long-term follow-up care for childhood cancer survivors: A systematic review

Ist Teil von

• Critical reviews in oncology/hematology, 2017-06, Vol.114, p.131-138

Ort / Verlag

Netherlands: Elsevier B.V

Erscheinungsjahr

2017

Quelle

MEDLINE

Beschreibungen/Notizen

• Abstract Objectives Childhood cancer survivors are at risk of developing late treatment-related complications. In response, many hospitals worldwide have established follow-up clinics to monitor survivors as they age. However, there is limited evidence of the efficacy of these clinics in meeting the lifelong healthcare needs of survivors. In this review we collated evidence of the measurable impact of engagement in specialized survivorship care, on survivors’ medical and psychosocial outcomes. Design We conducted a systematic review according to PRISMA guidelines, and assessed the quality of included studies using ‘QualSyst’. Data sources We screened 641 abstracts in Medline, Embase and CINAHL, yielding 9 eligible articles (N = 5135 survivors). Eligibility criteria for selecting studies Articles were eligible if: participants were diagnosed with cancer prior to the age of 21; participants were classified as ‘survivors’ of childhood or adolescent cancer, usually defined as 5 years from diagnosis or 2 years from the end of treatment; studies evaluated the impact of engagement in long term follow-up (LTFU) care on medical, psychosocial or other outcomes in pediatric cancer survivors. Results One article evaluated primary care physician-led follow-up and the remainder evaluated specialized survivorship clinics. Survivors attending follow-up care tended to demonstrate higher knowledge about their treatment and diagnosis (n = 2), and had more accurate late effects risk perception (n = 3). Attendees also engaged in increased more regular surveillance, had fewer emergency department visits/hospitalizations (n = 1), and more late effects detected (n = 3), than non-attendees. Conclusions There is a dearth of literature systematically evaluating the medical and psychosocial impact of follow-up care. Research suggests however, survivors engaged in follow-up care have better health and educational outcomes, highlighting the need for lifelong survivorship care and ongoing late effects education for survivors. Recalling survivors who become disengaged with follow-up care is also valuable, as their risk of treatment-related complications rises with age. Further systematic evaluation is urgently needed.