Abstract 17274: Frequency of Cardiology Follow-Up in Childhood Cancer Patients

Abstract

Background: Childhood cancer survivors (CCS) are at risk of early or late-stage cardiotoxicity, the third leading cause of death in CCS. American Heart Association Scientific statement stresses the importance of timely follow-up of CCS. Children's Oncology Group (COG) has also recommended serial cardiac testing based on therapy doses. However, compliance of cardiac follow-up is not known. Hypothesis: Cardiology follow-up in CCS is poor and needs improvement. Goal: Our goal is to identify factors that limit timely cardiology follow-up. Methods: We retrospectively cross-referenced patients from the oncology clinic with our echocardiogram database, focusing on solid tumor survivors from 1996-2018 that received anthracyclines or cardiac field radiation. Excluding patients not requiring cardiac monitoring, we collected demographic, oncology history and treatment, and cardiac evaluation related data. Based on COG guidelines, we determined if each patient maintained their expected cardiology follow up. We then assessed whether follow up was associated with median household income, medical insurance type, gender, and age at diagnosis using chi square or t-test. Results: A total of 49 patients (24F/25M) met inclusion criteria included. Timely cardiology follow up was only seen in 50% of the patients, regardless of how far out the patients were from treatment. There was no correlation between follow up and median household income, medical insurance, gender, or age of diagnosis (p values >0.05). Conclusions: This data demonstrates there is a major gap in providing key cardiac care to CCS, as 50% of patients did not maintain expected follow up. This finding was irrespective of socioeconomic status or age at diagnosis. This suggests a greater emphasis must be placed on educating families about potential cardiac risks and the need for appropriate follow up care. This can be established through a stronger collaboration between cardiology and oncology programs.