Cancer Survivor Clinics Can Reduce ED Utilization, Study Shows

A government-funded network of specialized survivor clinics in Ontario, Canada, significantly decreased emergency department (ED) visits among adult survivors of childhood cancer.

Researchers at the University of Toronto devised a population-based, retrospective cohort study to determine the association between prior attendance at survivor clinics by adult survivors of pediatric cancer and ED use. Data from survivors diagnosed with cancer during the period between January 1, 1986, and December 31, 2005, were included in the study published in the journal Cancer.

Of the more than 3900 participants in the study, those who had had at least 1 prior visit to a survivor clinic had a 19% reduction in rate of ED visits compared with individuals who had not visited a survivor clinic (adjusted relative rate, 0.81; 95% confidence interval (CI), 0.78-0.85). Every additional visit to the survivor clinic decreased the rate of ED utilization even further.

“The growing number of childhood cancer survivors has reached a tipping point that has compelled the creation of a clinical field focused on survivor care,” said senior author Paul Nathan, MD, MSc, FRPC, director of a survivor program at the Hospital for Sick Children in Toronto. With significantly improved survival among childhood cancer patients, the “quality of the cure” is gaining increased focus from physicians, according to Nathan.

The aim of the survivorship clinics is to provide additional support to pediatric cancer survivors, over and above the care of their oncologist and primary care physician. Their focus, per Nathan, is helping patients identify and address physical and mental health effects that could be associated with the cancer therapy they received several years earlier.

Being patient-centered, these clinics recognize the long-term effects of cancer treatment that can spring up later in life.