Abstract
As the treatment of cancer is becoming more successful, there is a growing population of cancer survivors. For patients diagnosed with a cancer prior to the age of 21 years, over 80% will be cured and as a result there are more than 350,000 survivors of childhood cancer currently living in the US. Research in large cohorts of childhood cancer survivors indicate these patients are at significant risk of premature mortality due to late effects and second cancers due to their previous therapy. Recognizing this, in 2003, the Institute of Medicine has recommended lifelong, risk-based long term follow up care focused on monitoring for cancer recurrence, surveillance and early intervention of late effects, and second cancers and education. Despite these recommendations, survivors are not receiving risk based care. There are many barriers to medical care in this vulnerable population. Many of these patients are young adults and not able to secure employment and/or insurance. Our research has indicated that primary care physicians who follow patients in the community are not aware of the risks and surveillance guidelines for these patients. Further, most survivors and their primary care physicians report that they do not have a treatment summary and follow up plan. These issues are likely compounded in disadvantaged populations. Research must be focused on examining risk of late effects and second cancers in minority populations in order to tailor surveillance recommendations. Intervention studies must be designed that are focused on the dissemination of treatment summaries and care plans for survivors not cared for in tertiary care centers, but in the community. Specific education must be in place at the time of cancer care such that patients are aware of their risks and need for long term follow up care. Policy measures must include focused efforts for disadvantaged survivors in order to ensure appropriate health care coverage to meet their significant and specialized health care needs.
Citation Format: Tara O. Henderson. Cancer survivors: Opportunities and challenges in managing comorbidities among disadvantaged populations. [abstract]. In: Proceedings of the Sixth AACR Conference: The Science of Cancer Health Disparities; Dec 6–9, 2013; Atlanta, GA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2014;23(11 Suppl):Abstract nr CN01-04. doi:10.1158/1538-7755.DISP13-CN01-04