Publicatie datum

Health care use after diagnosis of cancer in children.

Heins, M.J., Lorenzi, M.F., Korevaar, J.C., McBride, M.L. Health care use after diagnosis of cancer in children. European Journal of Cancer Care: 2014, 23(suppl. 1), p. 2-3.
Purpose: Young patients with cancer often require extensive
care during and shortly after cancer treatment for medical, psychosocial
and educational problems. Approximately 85% are
treated by an oncologist; however, their additional health care
in this phase has barely been studied. The role of the family
physician in this period is therefore unknown.
Methods: We included all patients diagnosed with cancer from
1991 to 2001 under age 24 in British Columbia, Canada, and
followed them from 1991 to 2006. We identified 10 controls for
each case, matched by birth year and sex. Using data from the
provincial health insurance plan, we determined the number of
family physician and non-cancer specialist visits in the 5 years
after diagnosis of the patient.
Results: Seven hundred fifty-seven children were diagnosed
under age 15, and 774 adolescents and young adults (AYAs)
between ages 15 and 24. Half were male; the most common
diagnoses were leukaemia and lymphoma. In the first 5 years
after diagnosis, patients visited their family physician and noncancer
specialist significantly more than controls. Younger
patients had more specialist visits than AYAs, especially in the
first year (on average 20 vs. 10 visits). The percentage visiting a specialist decreased faster in AYAs than in younger patients (to
49% and 76%, respectively). The most common reasons for a
family physician visit were ‘neoplasm-related’ and ‘general
symptoms’. The family physician was also visited for regular
age-specific health problems at the same rate as controls. Specialist
visits among AYAs were largely related to neoplasms,
while younger patients visited their specialist for a variety of
Conclusion: Both non-cancer specialists and family physicians
are involved in the care for children and AYAs with cancer in
the first years after diagnosis. This will facilitate transition
from the clinic to long-term care, but also stresses the importance
of good communication between all physicians involved. (aut. ref.)