Quality of health care for childhood cancer survivors depends in part on the type of community they live in

Childhood cancer survivors should receive healthcare that includes regular medical screenings tailored to their unique therapy-related risks, known as "risk-based" care.

Published: 3/15/2017

Man and woman at table

To protect their health throughout their lives, childhood cancer survivors should receive healthcare that includes regular medical screenings tailored to their unique therapy-related risks, known as “risk-based” care. Unfortunately, less than one-third of long-term survivors receive this level of care. 

What factors influence who will receive risk-based care? 

We already know that an individual’s personal circumstances can affect the type and quality of healthcare he or she receives. For example, survivors who have a low-income, are unemployed, or don’t have health insurance often lack medical care or may receive only general care, not the survivor focused care they need.  Other personal factors, such as poor physical or emotional health or lack of social support might also have an effect.

A team of LTFU Study researchers examined how external factors, such as the income level and number of people living in an individual’s surrounding community, or the number of doctors in the local geographic area, might affect the type of care survivors receive.

The team analyzed information provided by almost 8,000 LTFU study participants from the U.S. and Canada. They found that overall such external factors did have an effect on survivors’ access to risk-based care, though not a big one. Specifically, they found that:

  1. Regardless of an individual’s personal income, living in a higher-income area slightly increased the chance of receiving a screening echocardiogram for survivors at risk of heart disease.
  2. Living in an area with a greater number of doctors increased the chance of receiving a recommended screening echocardiogram.
  3. Living in a higher-income area also slightly increased a participant’s chance of receiving risk-based care that included recommended health screenings.

Interestingly, for the U.S. participants, those living near a LTFU Study participating center had a higher chance of receiving risk-based, survivor-focused care.

What does this mean for you?

Survivors need access to risk-based, survivor-focused healthcare to help them stay on top of health problems that may be caused by treatment for childhood cancer. You can help yourself obtain this type of quality care by sharing the details of your treatment history with all of your health care providers.

Another resource to share with your doctor: The Children’s Oncology Group Survivorship Guidelines and Health Links, available online at www.survivorshipguidelines.org. This important resource contains information for both providers and patients. It lists the recommended health screenings you should receive based on your specific childhood illness and treatment.


Caplin DA, Smith KR, Ness KK, et al. Effect of Population Socioeconomic and Health System Factors on Medical Care of Childhood Cancer Survivors: A Report From the Childhood Cancer Survivor Study. J Adolesc Young Adult Oncol. 2017, 6(1), 74-82.