• Jacqueline Casillas, Kevin C Oeffinger, Melissa M Hudson, Mark L Greenberg, Mark W Yeazel, Kirsten K Ness, Tara O Henderson, Leslie L Robison, Gregory T Armstrong, Qi Liu, Wendy Leisenring, Yutaka Yasui, and Paul C Nathan.
• Department of Pediatrics, University of California, Los Angeles, CA.
• Health Serv Res. 2015 Aug 1;50(4):1021-42.

ObjectivesCharacterize longitudinal changes in the use of medical care in adult survivors of childhood cancer.Data SourcesThe Childhood Cancer Survivor Study, a retrospective cohort study of 5+ year survivors of childhood cancer.Study DesignMedical care was assessed at entry into the cohort (baseline) and at most recent questionnaire completion. Care at each time point was classified as no care, general care, or survivor-focused care.Data CollectionThere were 6,176 eligible survivors. Multivariable models evaluated risk factors for reporting survivor-focused care or general medical care at baseline and no care at follow-up; and survivor-focused care at baseline and general care at follow-up.Principal FindingsMales (RR, 2.3; 95 percent CI 1.8-2.9), earning <$20,000/year (RR, 1.6; 95 percent CI 1.2-2.3) or ≤ high school education (RR, 2.5; 95 percent CI 1.6-3.8 and RR 2.0; 95 percent CI 1.5-2.7 for ConclusionsWhile the incidence of late effects increases over time for survivors, the likelihood of receiving survivor-focused care decreases for vulnerable populations.© Health Research and Educational Trust.

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