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Specialized survivor clinic attendance is associated with decreased rates of emergency department visits in adult survivors of childhood cancer

Sutradhar R, Agha M, Pole J, Greenberg M, Guttmann A, Hodgson D, Nathan P. Cancer. 2015; 121(24):4389-97. Epub 2015 Sep 25.


Purpose — Survivors of childhood cancer have considerable risk of experiencing treatment-related adverse health outcomes. To provide survivors with specialized care focused on these risks during adulthood, the government of Ontario funded a provincial network of specialized survivor clinics in 1999. Our aim was to determine whether prior attendance at survivor clinics by adult survivors of childhood cancer was associated with rates of emergency department (ED) visits.

Patients and Methods — This was a population-based retrospective cohort study using multiple, linked administrative health databases. The cohort consisted of all adult survivors of childhood cancer diagnosed between January 1, 1986 and December 31st, 2005 in Ontario, Canada. We used a recurrent event regression model to evaluate the association between prior attendance at survivor clinics and rate of ED visits, adjusted for individual, demographic, treatment, and provider characteristics.

Results — The study consisted of 3912 adult survivors of childhood cancer. Individuals who had at least one prior visit to a survivor clinic had a 19% decreased rate of ED visits compared to individuals who had not visited a survivor clinic (adjusted RR=0.81, 95% CI 0.78-0.85). Each additional prior visit to a survivor clinic was associated with a 5% decrease in the rate of ED visits (adjusted RR=0.95, 95% CI 0.93-0.96). These results were independent of whether or not survivors received care from a primary care physician.

Conclusion — Attendance at a specialized survivor clinic was significantly associated with decreased ED visits among adult survivors of childhood cancer.

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Keywords: Cancer Emergency department visits Childhood diseases

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