Survivor typologies predict medical surveillance participation: the childhood cancer survivor study
Article first published online: 11 SEP 2012
Copyright © 2012 John Wiley & Sons, Ltd.
Volume 22, Issue 7, pages 1534–1542, July 2013
How to Cite
Cox, C. L., Zhu, L., Hudson, M. M., Steen, B. D., Robison, L. L. and Oeffinger, K. C. (2013), Survivor typologies predict medical surveillance participation: the childhood cancer survivor study. Psycho-Oncology, 22: 1534–1542. doi: 10.1002/pon.3167
- Issue published online: 5 JUL 2013
- Article first published online: 11 SEP 2012
- Manuscript Accepted: 3 AUG 2012
- Manuscript Revised: 1 AUG 2012
- Manuscript Received: 16 APR 2012
- National Institutes of Health. Grant Numbers: R03 NR009203, U24 CA55727, P30 CA 21765
- childhood cancer;
- late effects;
- pediatric oncology
Adult survivors of childhood cancer adhere poorly to recommended medical surveillance. We sought to identify modifiable factors that contribute to non-adherence.
Latent class analysis categorized survivors (ages 18–52 years) at risk of cardiac, breast, or bone late sequelae on the basis of their health-related concerns, fears, and motivation. These classifications were compared at two time points for self-reported adherence to recommended echocardiography, mammography, and bone densitometry screening.
Three classes (worried, collaborative, and self-controlling) characterized survivors in each of the three risk groups: cardiac (N = 564; Bayesian information criterion [BIC] = 10,824.66; Lo–Mendell–Rubin parametric likelihood ratio test [LRMLRT] P = .002), breast (N = 584; BIC = 11,779.97; LRMLRT P < .001), and bone (N = 613; BIC = 11,773.56; LMRLRT P = .028). Only 9% of at-risk survivors in the self-controlling class reported undergoing bone density screening in 2005, compared with 17.2% in the collaborative class (P = .034). Thirteen percent of the self-controlling, 24% of collaborative (P = .025), and 34% of worried (P = .010) classes reported undergoing bone densitometry in 2009. Whereas 73% of at-risk survivors in the worried class reported having had an echocardiogram in 2009, only 57% of the collaborative (P = .040) and 43% of self-controlling (P < .001) classes did. In 2005 and 2009, respectively, fewer survivors in the self-controlling class (37% and 53%) than in the collaborative (51%, P = .038 and 70%, P = .01) and worried (58%, P = .002 and 69%, P = .025) classes reported undergoing mammograms.
Modifiable intrapersonal characteristics associated with these three classes predict self-reported participation in medical surveillance. Continued observation and validation of these survivor profiles may inform tailored interventions to enhance survivors' screening participation. Copyright © 2012 John Wiley & Sons, Ltd.