Eugene Suh, MD; Christopher K. Daugherty, MD; Kristen Wroblewski, MS; Hannah Lee, MPH; Mackenzie L. Kigin, BA; Kenneth A. Rasinski, PhD; Jennifer S. Ford, PhD; Emily S. Tonorezos, MD; Paul C. Nathan, MD, MSc; Kevin C. Oeffinger, MD; Tara O. Henderson, MD, MPH
Acknowledgment: The authors thank the Lisa Klitzky Foundation and the Ted Mullin Fund.
Grant Support: By the National Cancer Institute (grant NIH K07CA134935, “Health Beliefs and Behaviors: Cohort Studies in Childhood Cancer Survivors,” awarded 1 September 2008 through 30 August 2012, to Dr. Henderson).
Potential Conflicts of Interest: Disclosures can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M13-1941.
Reproducible Research Statement: Study protocol: Survey instrument available from Dr. Henderson (e-mail, firstname.lastname@example.org). Statistical code and data set: Not available.
Requests for Single Reprints: Tara O. Henderson, MD, MPH, University of Chicago Medicine Comer Children's Hospital, Pediatric Hematology/Oncology and Stem Cell Transplantation, 5841 South Maryland Avenue, MC 4060, Chicago, IL 60637; e-mail, email@example.com.
Current Author Addresses: Dr. Suh: Loyola University Medical Center, 2160 South First Avenue, Maywood, IL 60153.
Dr. Daugherty: University of Chicago, Department of Medicine, 5841 South Maryland Avenue, MC 2115, Chicago, IL 60637.
Ms. Wroblewski: University of Chicago, Department of Health Studies, 5841 South Maryland Avenue, MC 2007, Chicago, IL 60637.
Ms. Lee: 3723A Oregon Court, Great Lakes, IL 60088.
Ms. Kigin: 3215 Grand Avenue Unit 10, Des Moines, IA 50312.
Dr. Rasinski: University of Chicago Pritzker School of Medicine, Department of Medicine, 5841 South Maryland Avenue, Chicago, IL 60637.
Dr. Ford: Department of Psychiatry and Behavioral Sciences, Department of Pediatrics Memorial Sloan-Kettering Cancer Center, 641 Lexington Avenue, 7th Floor, New York, NY 10022.
Dr. Tonorezos: Memorial Sloan-Kettering Cancer Center, Department of Medicine, 300 East 66th Street, New York, NY 10065.
Dr. Nathan: Hospital for Sick Children, Division of Hematology/Oncology, 555 University Avenue, Toronto, Ontario M5G 1X8, Canada.
Dr. Oeffinger: Memorial Sloan-Kettering Cancer Center, Departments of Medicine and Pediatrics, 300 East 66th Street, Office 907, New York, NY 10065.
Dr. Henderson: University of Chicago Comer Children's Hospital, Pediatric Hematology/Oncology and Stem Cell Transplantation, 5841 South Maryland Avenue, MC 4060, Chicago, IL 60637.
Author Contributions: Conception and design: E. Suh, C.K. Daugherty, K.A. Rasinski, E.S. Tonorezos, K.C. Oeffinger, T.O. Henderson.
Analysis and interpretation of the data: E. Suh, C.K. Daugherty, K. Wroblewski, H. Lee, J.S. Ford, E.S. Tonorezos, K.C. Oeffinger, T.O. Henderson.
Drafting of the article: E. Suh, H. Lee, J.S. Ford, E.S. Tonorezos, T.O. Henderson.
Critical revision of the article for important intellectual content: E. Suh, C.K. Daugherty, K. Wroblewski, J.S. Ford, E.S. Tonorezos, P.C. Nathan, K.C. Oeffinger, T.O. Henderson.
Final approval of the article: E. Suh, C.K. Daugherty, K. Wroblewski, J.S. Ford, E.S. Tonorezos, P.C. Nathan, K.C. Oeffinger, T.O. Henderson.
Provision of study materials or patients: C.K. Daugherty, K.A. Rasinski, T.O. Henderson.
Statistical expertise: C.K. Daugherty, K.A. Rasinski, K. Wroblewski, T.O. Henderson.
Obtaining of funding: T.O. Henderson.
Administrative, technical, or logistic support: C.K. Daugherty, H. Lee, M.L. Kigin, K.A. Rasinski, T.O. Henderson.
Collection and assembly of data: E. Suh, C.K. Daugherty, H. Lee, M.L. Kigin, T.O. Henderson.
Suh E, Daugherty CK, Wroblewski K, Lee H, Kigin ML, Rasinski KA, et al. General Internists’ Preferences and Knowledge About the Care of Adult Survivors of Childhood Cancer: A Cross-sectional Survey. Ann Intern Med. 2014;160:11-17. doi: 10.7326/M13-1941
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Published: Ann Intern Med. 2014;160(1):11-17.
Adult childhood cancer survivors (CCSs) are at high risk for illness and premature death. Little is known about the physicians who provide their routine medical care.
To determine general internists’ self-reported attitudes and knowledge about the care of CCSs.
Mailed survey delivered between September 2011 and August 2012.
Random sample of 2000 U.S. general internists.
Care preferences, comfort levels with caring for CCSs (7-point Likert scale: 1 = very uncomfortable, 7 = very comfortable), familiarity with available surveillance guidelines (7-point Likert scale: 1 = very unfamiliar, 7 = very familiar), and concordance with Children's Oncology Group Long-Term Follow-Up Guidelines in response to a clinical vignette.
The response rate was 61.6% (1110 of 1801). More than half the internists (51.1%) reported caring for at least 1 CCS; 72.0% of these internists never received a treatment summary. On average, internists were “somewhat uncomfortable” caring for survivors of Hodgkin lymphoma, acute lymphoblastic leukemia, and osteosarcoma. Internists reported being “somewhat unfamiliar” with available surveillance guidelines. In response to a clinical vignette about a young adult survivor of Hodgkin lymphoma, 90.6% of respondents did not appropriately recommend yearly breast cancer surveillance, 85.1% did not appropriately recommended cardiac surveillance, and 23.6% did not appropriately recommend yearly thyroid surveillance. Access to surveillance guidelines and treatment summaries were identified as the most useful resources for caring for CCSs.
Findings, based on self-report, may not reflect actual clinical practice.
Although most general internists report involvement in the care of CCSs, many seem unfamiliar with available surveillance guidelines and would prefer to follow patients in collaboration with a cancer center.
National Cancer Institute.
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Cancer Survivorship, Hematology/Oncology.
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