Abstract
Background: Cancer late effects clinics are important to manage health complications experienced by cancer survivors, but little is known about potential barriers to attendance in rural states where many patients live far away from cancer centers. We identify demographic, clinical and residency factors associated with clinic attendance at the only pediatric cancer late effects clinic in Utah.
Methods: Medical records identified survivors diagnosed with cancer at age ≤25 years from 1986-2011 who currently reside in Utah. We linked records to the late effects clinic patient registry, available from 2010 to present. Participants were geocoded using their most recent residential zip code according to medical and driver's license records. The Euclidean distance between the clinic and the centroid of each zip code were calculated. Participants were classified into median income brackets based on the same zip code information. Log-linear models identified associations between attendance and the demographic and clinical factors. Generalized estimating equations were used in analyses for zip-code level residential distance and income with attendance.
Results: Of 1,935 survivors, only 10% had ≥1 clinic visit. Attendance is associated with leukemia/lymphoma diagnosis (odds ratio [OR]=1.65; 95% confidence interval [CI]=1.14-2.39 vs. other solid tumors) and current age between 19-30 years (OR=3.01; 95% CI=1.33-6.79 vs. ≥30 years). Hispanic ethnicity was not associated with late effects clinic attendance (OR=0.94; 95% CI =0.47-1.87 vs Non-Hispanic). Living in a zip code with a residential distance of less than 20 miles (OR=1.37, 95% CI=0.73-2.58 vs. ≥60 miles), and living in zip codes with median income between $60,000 and $70,000 (OR=1.45, 95% CI=0.67-3.11 vs. >$50,000/year) showed positive, non-significant associations with attendance.
Conclusions: Late effects clinics are not widely attended by childhood and adolescent cancer survivors in Utah. Current age and previous cancer diagnosis are associated with attendance. Area of residence and income show possible associations with clinic attendance, although more investigation is needed to examine how these access-related factors influence attendance. Outreach efforts may be needed to connect cancer survivors with late effects clinics. Further investigation is needed to identify potential economic and geographic barriers to care.
Citation Format: Judy Y. Ou, Rochelle R. Smits-Seemann, Jennifer A. Wright, Anne C. Kirchhoff. Pediatric Cancer Late Effects Clinic Patients in Utah: Potential Barriers to Care. [abstract]. In: Proceedings of the Ninth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2016 Sep 25-28; Fort Lauderdale, FL. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2017;26(2 Suppl):Abstract nr B19.
RSS Feeds