Access to risk-based survivor care

92.8% of survivors reported receiving some form of medical care in the previous year.[58]

Nearly 40% reported receiving care that focused on their previous cancer (survivor-focused care).[58]

Surveillance for new cases of cancer was very low in survivors at the highest risk of colon, breast, or skin cancer, suggesting that survivors and their physicians need education about the risk of subsequent neoplasms and recommended surveillance.[59]

Sociodemographic factors have been linked to declining rates of follow-up care over time from diagnosis. CCSS participants who were male, had a household income of less than $20,000 per year, and had lower educational attainment (high school education or less) were more likely to report no care at their most recent follow-up survey. This trend is concerning because the prevalence of chronic health conditions increases with longer elapsed time from cancer diagnosis in adults treated for cancer during childhood.[60]

A study that included 975 adult survivors of childhood cancer identified factors associated with attending the recommended risk-based, cancer-related medical visits. The relative risk of having a cancer-related visit was higher among survivors who:[61]

A study that included 975 adult survivors of childhood cancer identified factors associated with attending the recommended risk-based, cancer-related medical visits. The relative risk of having a cancer-related visit was higher among survivors who:[61]

Assigned a greater importance to these visits.

A study that included 975 adult survivors of childhood cancer identified factors associated with attending the recommended risk-based, cancer-related medical visits. The relative risk of having a cancer-related visit was higher among survivors who:[61]

Perceived a greater susceptibility to health problems.

A study that included 975 adult survivors of childhood cancer identified factors associated with attending the recommended risk-based, cancer-related medical visits. The relative risk of having a cancer-related visit was higher among survivors who:[61]

Had experienced a cancer-related chronic health problem that was moderate to life-threatening.

A study that included 975 adult survivors of childhood cancer identified factors associated with attending the recommended risk-based, cancer-related medical visits. The relative risk of having a cancer-related visit was higher among survivors who:[61]

Were seeing a primary care provider for a cancer-related problem.

A study that included 975 adult survivors of childhood cancer identified factors associated with attending the recommended risk-based, cancer-related medical visits. The relative risk of having a cancer-related visit was higher among survivors who:[61]

Had received a cancer treatment care plan.

A study that included 975 adult survivors of childhood cancer identified factors associated with attending the recommended risk-based, cancer-related medical visits. The relative risk of having a cancer-related visit was higher among survivors who:[61]

Expressed greater confidence in physicians’ abilities to address questions and concerns.

Cancer-related visits. In the CCSS, uninsured survivors were less likely than those privately insured to report a cancer-related visit (adjusted relative risk, 0.83; 95% CI, 0.75–0.91) or a cancer center visit (adjusted relative risk, 0.83; 95% CI, 0.71–0.98). Uninsured survivors had lower levels of utilization in all measures of care than privately insured survivors. In contrast, publicly insured survivors were more likely to report a cancer-related visit (adjusted relative risk, 1.22; 95% CI, 1.11–1.35) or a cancer center visit (adjusted relative risk, 1.41; 95% CI, 1.18–1.70) than were privately insured survivors.[62]

Health care outcomes. In a study comparing health care outcomes for long-term AYA cancer survivors with young adults who have no cancer history, the proportion of uninsured survivors did not differ between the two groups.[64]

Financial burden. Subgroups of adult survivors of childhood cancer may be at additional risk of health care barriers due to financial hardship. Younger survivors (aged 20–29 years), females, non-White survivors, and survivors reporting poorer health faced more cost barriers, which may inhibit the early detection of late effects.[64] Survivors are more likely than their siblings to forego needed medical care related to financial challenges.[65]