Marr KC, et al. – Authors performed this retrospective population–based study to determine if attendance at a specialized clinic for adult survivors of childhood cancer is related to better rates of adherence to the Children’s Oncology Group (COG) Long–term Follow–up (LTFU) guidelines for cardiomyopathy screening. They observed that increased clinic utilization was related to improved patient adherence to COG LTFU cardiomyopathy screening guidelines in a model of specialized survivor care.

Methods

• A retrospective population-based study was conducted using administrative data in Ontario, Canada of 5-year survivors diagnosed between 1986 and 2005 at risk of therapy-related late cardiomyopathy.
• Based on the recommended frequency of screening, patients were classified into 3 groups: annual, every 2 years, and every 5 years.

Results

• According to the findings obtained, of 1811 eligible survivors followed for median 7.8 years (range 0–14.0), patients were adherent to screening for only 8.6% of their period of follow-up.
• Findings revealed that survivor clinic utilization had the strongest association with increased rates of adherence: when compared to no attendance, ≥ 5 clinic visits/10-year period had RR of adherence of 10.6 (95% CI 5.7–19.5) in the annual group, 3.3 (95% CI 2.3–4.8) in the every two-year group, and 2.3 (95% CI 1.6–3.2) in the every five-year group.
• Additional factors related to increased adherence after adjusting for clinic attendance included annual assessment by a general practioner, female sex, diagnosis prior to 2003, and living in a rural area.