Randomized trial assessing the impact of survivorship care plans on the quality of care for childhood cancer survivors.

Patient and Survivor Care
Session Type and Session Title: 
Oral Abstract Session, Patient and Survivor Care
Abstract Number: 


J Clin Oncol 34, 2016 (suppl; abstr 10007)
Cary Philip Gross, Wilhelmenia Lee Ross, Jaime L. Rotatori, Hannah-Rose Mitchell, Xiaomei Ma, Nina S. Kadan-Lottick; Yale Cancer Center, New Haven, CT; Yale School of Medicine, New Haven, CT; Yale School of Public Health, New Haven, CT; Yale School of Medicine, Smilow Cancer Center, New Haven, CT

Abstract Disclosures


Background: The American College of Surgeons will soon mandate that all cancer survivors receive a survivorship care plan (SCP) to guide surveillance for late effects of therapy. However, the impact of care plans on the care of childhood cancer survivors is unclear. In this randomized trial we assessed the impact of SCPs on quality of care as defined by surveillance adherence and newly identified late effects. Methods: Patients were randomized to either receiving a customized SCP and being advised to follow up with their primary care physician, or attending a regional specialty survivor clinic (the often-cited gold standard). Eligibility included diagnosis with cancer at age <18 years in Connecticut during 2000-2012, ≥ 1 year off-therapy, currently cancer-free, fluent in English or Spanish, and no prior attendance at a specialty survivor clinic. Randomization was stratified by gender, age at evaluation, and radiation history. After the 12-month intervention period, research staff abstracted patient medical records for surveillance adherence and late effects. Results: Overall, 96 childhood cancer survivors (47% female; mean age at evaluation 15.9±6.1 years) were enrolled; 74% had chemotherapy and 36% radiation. Surveillance adherence was significantly worse in the SCP group for each test evaluated (Table). While only 1 late effect (grade 1) was identified in the SCP group, twenty-one late effects (Common Terminology for Adverse Events grades 1-3) were identified in the survivor clinic group. Conclusions: Based on surveillance adherence and newly identified late effects, our randomized trial suggests that solely delivering a SCP to patients is not sufficient to achieve high quality survivorship care.

Surveillance Adherence n (%)

Survivorship Care PlanSpecialty Survivor Clinicp-value
Echo3/20 (15)19/19 (100)<0.05
EKG0/20 (0)15/19 (80)<0.05
Pulmonary Function Test0/7 (0)6/6 (100)<0.05
Bone Density1/14 (7)14/15 (93)<0.05
Urinalysis11/23 (48)19/21 (90)<0.05
Blood Tests:
Liver2/11 (18)12/12 (100)<0.05
Renal8/21 (38)20/20 (100)<0.05
Thyroid4/10 (40)11/11 (100)<0.05
Newly Identified Late Effects
Grade 1113<0.05
Grade 207<0.05
Grade 3010.51