Predictors of colorectal cancer surveillance among survivors of childhood cancer treated with radiation: A report from the Childhood Cancer Survivor Study

Casey L. Daniel, Connie L. Kohler, Kayla L. Stratton, Kevin C. Oeffinger, Wendy M. Leisenring, John W. Waterbor, Kimberly F. Whelan, Gregory Armstrong, Tara O. Henderson, Kevin R. Krull, Leslie L. Robison, Paul C. Nathan

Research output: Contribution to journalArticle

7 Citations (Scopus)

Abstract

BACKGROUND 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. METHODS 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. RESULTS 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. CONCLUSIONS 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.

Original languageEnglish (US)
Pages (from-to)1856-1863
Number of pages8
JournalCancer
Volume121
Issue number11
DOIs
StatePublished - Jun 1 2015

Fingerprint

Colorectal Neoplasms
Radiation
Neoplasms
Confidence Intervals
Radiotherapy
Physicians
Radiation-Induced Neoplasms
Primary Care Physicians
Colonoscopy
Rectum
Linear Models
Colon
Multivariate Analysis

All Science Journal Classification (ASJC) codes

  • Oncology
  • Cancer Research

Cite this

Daniel, C. L., Kohler, C. L., Stratton, K. L., Oeffinger, K. C., Leisenring, W. M., Waterbor, J. W., ... Nathan, P. C. (2015). Predictors of colorectal cancer surveillance among survivors of childhood cancer treated with radiation: A report from the Childhood Cancer Survivor Study. Cancer, 121(11), 1856-1863. https://doi.org/10.1002/cncr.29265

Predictors of colorectal cancer surveillance among survivors of childhood cancer treated with radiation : A report from the Childhood Cancer Survivor Study. / Daniel, Casey L.; Kohler, Connie L.; Stratton, Kayla L.; Oeffinger, Kevin C.; Leisenring, Wendy M.; Waterbor, John W.; Whelan, Kimberly F.; Armstrong, Gregory; Henderson, Tara O.; Krull, Kevin R.; Robison, Leslie L.; Nathan, Paul C.

In: Cancer, Vol. 121, No. 11, 01.06.2015, p. 1856-1863.

Research output: Contribution to journalArticle

Daniel, CL, Kohler, CL, Stratton, KL, Oeffinger, KC, Leisenring, WM, Waterbor, JW, Whelan, KF, Armstrong, G, Henderson, TO, Krull, KR, Robison, LL & Nathan, PC 2015, 'Predictors of colorectal cancer surveillance among survivors of childhood cancer treated with radiation: A report from the Childhood Cancer Survivor Study', Cancer, vol. 121, no. 11, pp. 1856-1863. https://doi.org/10.1002/cncr.29265
Daniel, Casey L. ; Kohler, Connie L. ; Stratton, Kayla L. ; Oeffinger, Kevin C. ; Leisenring, Wendy M. ; Waterbor, John W. ; Whelan, Kimberly F. ; Armstrong, Gregory ; Henderson, Tara O. ; Krull, Kevin R. ; Robison, Leslie L. ; Nathan, Paul C. / Predictors of colorectal cancer surveillance among survivors of childhood cancer treated with radiation : A report from the Childhood Cancer Survivor Study. In: Cancer. 2015 ; Vol. 121, No. 11. pp. 1856-1863.
@article{1eb677ace855417b8a8d79a37a056320,
title = "Predictors of colorectal cancer surveillance among survivors of childhood cancer treated with radiation: A report from the Childhood Cancer Survivor Study",
abstract = "BACKGROUND 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. METHODS 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. RESULTS 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. CONCLUSIONS 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.",
author = "Daniel, {Casey L.} and Kohler, {Connie L.} and Stratton, {Kayla L.} and Oeffinger, {Kevin C.} and Leisenring, {Wendy M.} and Waterbor, {John W.} and Whelan, {Kimberly F.} and Gregory Armstrong and Henderson, {Tara O.} and Krull, {Kevin R.} and Robison, {Leslie L.} and Nathan, {Paul C.}",
year = "2015",
month = "6",
day = "1",
doi = "10.1002/cncr.29265",
language = "English (US)",
volume = "121",
pages = "1856--1863",
journal = "Cancer",
issn = "0008-543X",
publisher = "John Wiley and Sons Inc.",
number = "11",

}

TY - JOUR

T1 - Predictors of colorectal cancer surveillance among survivors of childhood cancer treated with radiation

T2 - A report from the Childhood Cancer Survivor Study

AU - Daniel, Casey L.

AU - Kohler, Connie L.

AU - Stratton, Kayla L.

AU - Oeffinger, Kevin C.

AU - Leisenring, Wendy M.

AU - Waterbor, John W.

AU - Whelan, Kimberly F.

AU - Armstrong, Gregory

AU - Henderson, Tara O.

AU - Krull, Kevin R.

AU - Robison, Leslie L.

AU - Nathan, Paul C.

PY - 2015/6/1

Y1 - 2015/6/1

N2 - BACKGROUND 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. METHODS 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. RESULTS 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. CONCLUSIONS 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.

AB - BACKGROUND 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. METHODS 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. RESULTS 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. CONCLUSIONS 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.

UR - http://www.scopus.com/inward/record.url?scp=84929655684&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84929655684&partnerID=8YFLogxK

U2 - 10.1002/cncr.29265

DO - 10.1002/cncr.29265

M3 - Article

C2 - 25649858

AN - SCOPUS:84929655684

VL - 121

SP - 1856

EP - 1863

JO - Cancer

JF - Cancer

SN - 0008-543X

IS - 11

ER -