Predictors of colorectal cancer surveillance among survivors of childhood cancer treated with radiation: A report from the Childhood Cancer Survivor Study. Issue 11 (3rd February 2015)

• Record Type: Journal Article
• Authors: Daniel, Casey L.; Kohler, Connie L.; Stratton, Kayla L.; Oeffinger, Kevin C.; Leisenring, Wendy M.; Waterbor, John W.; Whelan, Kimberly F.; Armstrong, Gregory T.; Henderson, Tara O.; Krull, Kevin R.; Robison, Leslie L.; Nathan, Paul C.
• Is Part Of: Cancer. Volume 121:Issue 11(2015)
• Page Start: 1856
• Page End: 1863
• Publication Date: 2015-02-03
• Subjects: Cancer -- Periodicals; Cancer -- Cytopathology -- Periodicals; 616.99405
• DOI: 10.1002/cncr.29265
• Languages: English
• ISSNs: 0008-543X

Abstract

<abstract abstract-type="main"> <title> <x xml:space="preserve">Abstract</x> </title> <sec id="cncr29265-sec-0001" sec-type="section"> <title>BACKGROUND</title> <p>Childhood cancer survivors treated with radiotherapy to a field including the colon or rectum have an elevated risk of developing radiation‐induced colorectal cancer (CRC). The Children's Oncology Group recommends colonoscopy every 5 years beginning at age 35 years for at‐risk survivors.</p> </sec> <sec id="cncr29265-sec-0002" sec-type="section"> <title>METHODS</title> <p>Analyses included 702 five‐year survivors (Childhood Cancer Survivor Study) aged ≥36 years who received ≥30 gray of abdominal, pelvic, or spinal radiotherapy. Multivariate generalized linear models were used to calculate relative risks (RR) with 95% confidence intervals (95% CI) for adherence to the Children's Oncology Group's CRC surveillance recommendations.</p> </sec> <sec id="cncr29265-sec-0003" sec-type="section"> <title>RESULTS</title> <p>With a median age of 43 years (range, 36‐58 years), 29.5% of the survivors (207 of 702 survivors) met surveillance recommendations. In multivariate analyses, age ≥50 years versus age 36 to 49 years (RR, 2.6; 95% CI, 2.0‐3.4), reporting a routine cancer follow‐up visit within 1 year before the study (RR, 1.5; 95% CI, 1.0‐2.2), reporting ≥10 physician visits within the past year versus 0 to 9 visits (RR, 1.4; 95% CI, 1.1‐1.7), and discussing future cancer risk with a physician at the time of the most recent follow‐up visit (RR, 1.4; 95% CI, 1.1‐1.7) were found to be associated with adherence to CRC surveillance recommendations.</p> </sec> <sec id="cncr29265-sec-0004" sec-type="section"> <title>CONCLUSIONS</title> <p>Greater than 70% of survivors at an increased risk of CRC were not screened as recommended. Regular physician contact and discussion of screening were associated with a 60% increase in CRC surveillance. Educational interventions targeted at survivors and their primary care physicians are needed to heighten knowledge of CRC risk after radiotherapy and the importance of appropriate surveillance. <bold><italic>Cancer</italic> 2015;121:1856–1863.</bold> © <italic>2015 American Cancer Society</italic>.</p> </sec> </abstract>