Childhood cancer survivorship care during the COVID-19 pandemic: an international report of practice implications and provider concerns

Selina R. van den Oever, Princess Máxima Center for Pediatric Oncology, Heidelberglaan 25, 3584 CS, Utrecht, the Netherlands. s.r.vandenoever-2@prinsesmaximacentrum.nl.
Saskia M. Pluijm, Princess Máxima Center for Pediatric Oncology, Heidelberglaan 25, 3584 CS, Utrecht, the Netherlands.
Rod Skinner, Great North Children's Hospital, and Translational and Clinical Research Institute, Newcastle University Centre for Cancer, Newcastle University, Newcastle upon Tyne, UK.
Adam Glaser, Leeds Institute of Medical Research, University of Leeds, Leeds, LS2 9JT, UK.Follow
Renée L. Mulder, Princess Máxima Center for Pediatric Oncology, Heidelberglaan 25, 3584 CS, Utrecht, the Netherlands.
Saro Armenian, City of Hope Comprehensive Cancer Center, Duarte, CA, USA.Follow
Edit Bardi, St Anna Childrens Hospital, Vienna, Austria.Follow
Claire Berger, Department for Pediatric Hematology and Oncology CHU Nord, University Hospital Saint-Etienne, Saint-Priest en Jarez, France.
Matthew J. Ehrhardt, Department of Oncology, St. Jude Children's Research Hospital, Memphis, TN, USA.
Jordan Gilleland Marchak, Department of Pediatrics at, Emory University School of Medicine, Aflac Cancer & Blood Disorders Center at Children's Healthcare of Atlanta, Atlanta, GA, USA.
Gabrielle M. Haeusler, Paediatric Integrated Cancer Centre, Victoria, Australia.Follow
Jaap den Hartogh, Dutch Childhood Cancer Parent Organization VOKK Netherlands, Department VOX Survivors, Nieuwegein, The Netherlands.
Lars Hjorth, Department of Paediatrics, Skåne University Hospital Clinical Sciences, Lund University, Lund, Sweden.
Tomas Kepak, University Hospital Brno & International Clinical Research Center (FNUSA-ICRC), Masaryk University, Brno, Czech Republic.
Izolda Kriviene, Republican Siauliai County Hospital, Siauliai, Lithuania.
Thorsten Langer, Pediatric Hematology and Oncology, Hospital for Children and Adolescents, University Hospital of Schleswig-Holstein, Campus Luebeck, Luebeck, Germany.
Miho Maeda, Department of Pediatrics, Nippon Medical School, Tokyo, Japan.
Catalina Márquez-Vega, Department of Pediatric Oncology, Hospital Virgen del Rocío, Sevilla, Spain.
Gisela Michel, Department of Health Sciences and Medicine, University of Lucerne, Frohburgstrasse 3, PO Box 4466, 6002, Lucerne, Switzerland.
Monica Muraca, Epidemiology and Biostatistics Unit and DOPO Clinic, IRCCS Istituto Giannina Gaslini, Genova, Italy.
Mohamed Najib, Hospital Tunku Azizah, Kuala Lumpur, Malaysia.
Paul C. Nathan, Division of Haematology/Oncology, The Hospital for Sick Children, Toronto, Canada.
Anna Panasiuk, Department of Paediatric Bone Marrow Transplantation, Oncology and Haematology, Medical University of Wroclaw, Wroclaw, Poland.
Maya Prasad, Paediatric Oncology, Tata Memorial Hospital, Mumbai, India.
Jelena Roganovic, Department of Pediatrics, Clinical Hospital Centre Rijeka and School of Medicine of the University of Rijeka, Rijeka, Croatia.
Anne Uyttebroeck, Department of Pediatric Hematology and Oncology, University Hospitals Leuven, Leuven, Belgium.
Jeanette F. Winther, Danish Cancer Society Research Center, Copenhagen, Denmark.
Lorna Zadravec Zaletel, Radiotherapy department, Institute of Oncology, Zaloska 2, 1000, Ljubljana, Slovenia.
Elvira C. van Dalen, Princess Máxima Center for Pediatric Oncology, Heidelberglaan 25, 3584 CS, Utrecht, the Netherlands.
Helena J. van der Pal, Princess Máxima Center for Pediatric Oncology, Heidelberglaan 25, 3584 CS, Utrecht, the Netherlands.
Melissa M. Hudson, Department of Oncology, St. Jude Children's Research Hospital, Memphis, TN, USA.
Leontien C. Kremer, Princess Máxima Center for Pediatric Oncology, Heidelberglaan 25, 3584 CS, Utrecht, the Netherlands.

Abstract

PURPOSE: Long-term follow-up (LTFU) care is essential to optimise health outcomes in childhood cancer survivors (CCS). We aimed to assess the impact of the COVID-19 pandemic on LTFU services and providers. METHODS: A COVID-19 working group within the International Late Effects of Childhood Cancer Guideline Harmonization Group (IGHG) distributed a questionnaire to LTFU service providers in 37 countries across Europe, Asia, North America, Central/South America, and Australia. The questionnaire assessed how care delivery methods changed during the pandemic and respondents' level of worry about the pandemic's impact on LTFU care delivery, their finances, their health, and that of their family and friends. RESULTS: Among 226 institutions, providers from 178 (79%) responded. Shortly after the initial outbreak, 42% of LTFU clinics closed. Restrictions during the pandemic resulted in fewer in-person consultations and an increased use of telemedicine, telephone, and email consultations. The use of a risk assessment to prioritise the method of LTFU consultation for individual CCS increased from 12 to 47%. While respondents anticipated in-person consultations to remain the primary method for LTFU service delivery, they expected significantly increased use of telemedicine and telephone consultations after the pandemic. On average, respondents reported highest levels of worry about psychosocial well-being of survivors. CONCLUSIONS: The pandemic necessitated changes in LTFU service delivery, including greater use of virtual LTFU care and risk-stratification to identify CCS that need in-person evaluations. IMPLICATIONS FOR CANCER SURVIVORS: Increased utilisation of virtual LTFU care and risk stratification is likely to persist post-pandemic.

Publication Title

Journal of cancer survivorship : research and practice

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