Research, policy and practice related to survivors of childhood, adolescent and young adult cancers in British Columbia (BC), Canada: A population-based approach

Abstract

9539 Background and Purpose: Prevalence of long term survivors of pediatric, adolescent and young adult cancers is increasing. In BC we are using a multidimensional population approach to address research and care for these survivors. Information on trends in prevalence of survivors and use of physician services are presented. Methods: We have identified a cohort of patients under 25, diagnosed from population registries since 1970, and linked their records with person-based longitudinal records of health utilization. Results: Prevalence rate of cancer survivors aged 0–59 years, originally diagnosed under age 25, increased 5 fold between 1975 and 2005, from 26 per 100,000 to 147 per 100,000; 78% were aged 20 or older. A total subgroup of 3,787 individuals surviving five years or more, diagnosed between 1970 and 1995, were identified; 2,590 (68%) of these were linked to physician visit records (excluding visits within BC's Children's Hospital) from 1986 to 2000. In year 2000, 77% of survivors had at least one physician visit; 75% of survivors saw a family physician (FP), and 44% of survivors visited a specialist physician with a specialty that could be related to a late effect. Between 1986 and 2000 survivor prevalence increased 3.3% per year; total visits by survivors to FPs increased by 11.6% per year and by 10.6% per year to specialists. In 1986, 66% of physician visits were for patients older than 20 which increased to 79% by 2000. A provincial pediatric oncology network consisting of oncologists and community care representatives has been established to implement changes to long-term follow up policy. Conclusion: The prevalence rate and utilization of health services among survivors of childhood, adolescent and young adult cancers continues to escalate. Research results, along with other published literature, will inform the development of policy and practice within the BC Network. No significant financial relationships to disclose.