Abstract
ObjectiveTo enhance the understanding of cardiovascular care delivery in childhood cancer patients and survivors.Study designA 20-question survey was created by the Pediatric Cardio-oncology Work Group of the American College of Cardiology (ACC) Cardio-oncology Section to assess the care, management, and surveillance tools utilized to manage pediatric/young adult cardio-oncology patients. The survey distribution was a collaborative effort between Cardio-oncology Section and membership of the Adult Congenital and Pediatric Cardiology Section (ACPC) of the ACC.ResultsSixty-five individuals, all self-identified as physicians, responded to the survey. Most respondents (n = 58,89%) indicated childhood cancer patients are regularly screened prior to and during cancer therapy at their centers, predominantly by electrocardiogram (75%), standard echocardiogram (58%) and advanced echocardiogram (50%) (i.e. strain, stress echo). Evaluation by a cardiologist prior to/during therapy was reported by only 8(12%) respondents, as compared to post-therapy which was reported by 28 (43%, p < 0.01). The most common indications for referral to cardiology at pediatric centers were abnormal test results (n = 31,48%) and history of chemotherapy exposure (n = 27,42%). Of note, during post-treatment counseling, common cardiovascular risk-factors like blood pressure (31,48%), lipid control (22,34%), obesity & smoking (30,46%) and diet/exercise/weight loss (30,46%) were addressed by fewer respondents than was LV function (72%).ConclusionsThe survey data demonstrates that pediatric cancer patients are being screened by EKG and/or imaging prior to/during therapy at most centers. Our data, however, highlight the potential for greater involvement of a cardiovascular specialist for pre-treatment evaluation process, and for more systematic cardiac risk factor counseling in posttreatment cancer survivors.
Highlights
Every year in the United States, cancer is diagnosed in more than 15,700 patients under 20-years of age [1]
The purpose of this survey was to improve understanding of what groups of young childhood cancer survivors are being followed by pediatric cardiologists and for which indications, and what guidelines, if any, cardiologists use in their evaluation, management, and follow-up of cancer survivors
46 (71%) were affiliated with an academic institution, 11 (17%) in a practice owned by a hospital or larger institution, and the remainder owned by a corporation (n = 4, 6%), either abnormality found on Children’s Oncology Group (COG) recommended testing
Summary
Every year in the United States, cancer is diagnosed in more than 15,700 patients under 20-years of age [1]. Members of the American College of Cardiology (ACC) Cardio-oncology Section and the ACC Pediatric Cardio-oncology Work Group, representing 15 different pediatric cardiology centers performed a practice survey of cardiology providers in the US caring for pediatric cancer patients. The purpose of this survey was to improve understanding of what groups of young childhood cancer survivors are being followed by pediatric cardiologists and for which indications, and what guidelines, if any, cardiologists use in their evaluation, management, and follow-up of cancer survivors
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