Utilization of cardiac tests in anthracycline‐treated cancer survivors differs between young adults and children: A claims‐based analysis

Author:

Ji Xu12ORCID,Hu Xin3ORCID,Lipscomb Joseph4,Chow Eric J.5,Mertens Ann C.12,Castellino Sharon M.12

Affiliation:

1. Department of Pediatrics Emory University School of Medicine Atlanta Georgia USA

2. Aflac Cancer & Blood Disorders Center, Children's Healthcare of Atlanta Atlanta Georgia USA

3. Department of Public Health Sciences University of Virginia School of Medicine Charlottesville Virginia USA

4. Department of Health Policy and Management, Rollins School of Public Health Emory University Atlanta Georgia USA

5. University of Washington School of Medicine and Fred Hutchinson Cancer Research Center Seattle Washington USA

Abstract

AbstractBackgroundThe Children's Oncology Group Guidelines recommend a cardiacechocardiogram, or comparable functional imaging, following therapy completion in survivors of childhood/adolescent cancers exposed to anthracyclines.MethodsUsing the 2009–2019 Merative™ MarketScan® Commercial Database, we examined real‐world utilization of cardiac testing among 1609 anthracycline‐treated survivors of childhood/adolescent cancers.ResultsThe cumulative incidence of receiving an initial cardiac test by 5.25 years from the index date (six months after end‐of‐therapy) was 62.3% (95% CI = 57.5%–66.7%), with median time to initial test being 2.7 years (95% CI = 2.5%–3.1%). Young adults (18–28 years) were less likely than children (≤17 years) to receive cardiac testing (hazard ratio [HR] = 0.42, 95% CI = 0.3%–0.49%). More likely to receive cardiac testing were survivors receiving hematopoietic stem cell transplantation versus chemotherapy only (HR = 2.23, 95% CI = 1.63%–3.03%), and survivors with bone or soft tissue versus hematologic cancer (HR = 1.64, 95% CI = 1.30%–2.07%).ConclusionsNearly 40% of anthracycline‐treated survivors of childhood/adolescent cancers had not received cardiac testing within 5.25 years post‐index date, with young adults least likely to receive a test.

Funder

Centers for Disease Control and Prevention

Publisher

Wiley

Subject

Cancer Research,Radiology, Nuclear Medicine and imaging,Oncology

Reference24 articles.

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