Physician preferences and knowledge gaps regarding the care of childhood cancer survivors: A survey of ASCO oncologists.

Abstract

9560 Background: Outside of the pediatric oncology specialty, little is known about physicians' attitudes and knowledge regarding the health care needs and long term follow-up care (LTFU) of childhood cancer survivors (CCS). We sought to obtain adult cancer physicians' self-reported attitudes and knowledge regarding this population. Methods: Following a pre-notification letter, surveys including a $5 gift card were mailed to 1,249 U.S. medical oncologists from the ASCO membership directory in November 2009. A second mailing to non-responders is planned. Results: In response to the first mailing, 346 surveys have been returned (28% response rate). Respondents' median age is 53 years (range: 33-79); 80% men; 30% practice in an academic medical center; 16% in a cancer center; 51% in private practice. Respondents practiced a median of 20 years (range: 1-41) and see a median of 60 patients/week (range: 0-700). When describing comfort levels in caring for CCS (1 = very uncomfortable; 7 = very comfortable), respondents were most comfortable with survivors > 30 years (mean ± SD 6.2 ±1.3), less comfortable with those >18 years and < 30 years (mean 5.7 ± 1.4), and least comfortable with CCS ≤ 18 years (mean 3.6 ± 2.0). In response to a vignette of a 26 year old female treated with mantle radiation at 16 years, based on available guidelines, 45% of respondents did not appropriately recommend yearly breast cancer surveillance; 84% did not appropriately recommend cardiac surveillance; and 55% did not appropriately recommend yearly thyroid screening. Only 4% of respondents answered all three questions in accordance with available guidelines, and those respondents were more likely to be familiar with the guidelines (p<0.05) and have received training in LTFU of CCS (p=0.02). Conclusions: Medical oncologists express a range of preferences with regard to LTFU of childhood cancer survivors. Many appear unfamiliar with LTFU surveillance guidelines. No significant financial relationships to disclose.