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Journal of Cancer Survivorship

Erschienen in:

24.07.2019 | Review

Interventions to improve adherence to surveillance guidelines in survivors of childhood cancer: a systematic review

verfasst von: Veda Zabih, Alyssa Kahane, Natalya E. O’Neill, Noah Ivers, Paul C. Nathan

Erschienen in: Journal of Cancer Survivorship | Ausgabe 5/2019

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Abstract

Purpose

Many survivors of childhood cancer are at high risk of late effects of their cancer therapy, including cardiac toxicity and subsequent malignant neoplasms (SMN). Current North American guidelines recommend periodic surveillance for these late effects. We conducted a systematic review of the literature to estimate rates of adherence to recommended surveillance and summarize studies evaluating interventions intended to increase adherence.

Methods

We searched MEDLINE, Embase, Web of Science, and the Cumulative Index of Nursing and Allied Health Literature (CINAHL) for articles published between January 2000 and September 2018 that reported adherence to surveillance for cardiac toxicity and SMN (breast and colorectal cancer) and interventions implemented to improve completion of recommended testing. Risk of bias was assessed using relevant Cochrane checklists. Due to heterogeneity and overlapping study populations, we used narrative synthesis to summarize the findings. This review was registered in PROSPERO: CRD42018098878.

Results

Thirteen studies met our inclusion criteria for assessing adherence to surveillance, while five assessed interventions to improve rates of surveillance. No studies met criteria for low risk of bias. Completion of recommended surveillance was lowest for colorectal cancer screening (11.5–30.0%) followed by cardiomyopathy (22.3–48.1%) and breast cancer (37.0–56.5%). Factors such as patient-provider communication, engagement with the health care system, and receipt of information were consistently reported to be associated with higher rates of surveillance. Of five randomized controlled trials aimed at improving surveillance, only two significantly increase completion of recommended testing—one for echocardiography and one for mammography. Both involved telephone outreach to encourage and facilitate these tests.

Conclusion

The majority of childhood cancer survivors at high risk of cardiac toxicity or SMN do not receive evidence-based surveillance. There is paucity of rigorous studies evaluating interventions to increase surveillance in this population.

Implications for Cancer Survivors

Robust trials are needed to assess whether tailored interventions, designed based on unique characteristics and needs of each survivor population, could improve adherence.

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Titel: Interventions to improve adherence to surveillance guidelines in survivors of childhood cancer: a systematic review
verfasst von: Veda Zabih
Alyssa Kahane
Natalya E. O’Neill
Noah Ivers
Paul C. Nathan
Publikationsdatum: 24.07.2019
Verlag: Springer US
Erschienen in: Journal of Cancer Survivorship / Ausgabe 5/2019
Print ISSN: 1932-2259
Elektronische ISSN: 1932-2267
DOI: https://doi.org/10.1007/s11764-019-00790-w

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Live-Webinar: Aktuelle Leitlinien bei Herz-Kreislauf-Erkrankungen

Springer Medizin

Interventions to improve adherence to surveillance guidelines in survivors of childhood cancer: a systematic review

Abstract

Purpose

Methods

Results

Conclusion

Implications for Cancer Survivors

Neu im Fachgebiet Onkologie

Prostatakarzinom: EU initiiert neues Screeningkonzept

Blasenkarzinom – Biomarker statt Zytologie?

Stereotaktische Radiatio schlägt konventionelle Bestrahlung

Adjuvante Brustkrebstherapie: Doppelt hält besser

Update Onkologie

Live-Webinar: Aktuelle Leitlinien bei Herz-Kreislauf-Erkrankungen

Springer Medizin

Abstract

Purpose

Methods

Results

Conclusion

Implications for Cancer Survivors

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