Prevalence of carotid ultrasound screening in survivors of childhood cancer: A report from the Childhood Cancer Survivor Study

IF 6.1 2区 医学 Q1 ONCOLOGY Cancer Pub Date : 2024-10-10 DOI:10.1002/cncr.35591
Yolanda Bryce MD, Jillian A. Whitton MS, Kayla L. Stratton MS, Wendy M. Leisenring ScD, Eric J. Chow MD, MPH, Gregory Armstrong MD, Brent Weil MD, MPH, Bryan Dieffenbach MD, Rebecca M. Howell PhD, MS, Kevin C. Oeffinger MD, Paul C. Nathan MD, MSc, Emily S. Tonorezos MD, MPH
{"title":"Prevalence of carotid ultrasound screening in survivors of childhood cancer: A report from the Childhood Cancer Survivor Study","authors":"Yolanda Bryce MD,&nbsp;Jillian A. Whitton MS,&nbsp;Kayla L. Stratton MS,&nbsp;Wendy M. Leisenring ScD,&nbsp;Eric J. Chow MD, MPH,&nbsp;Gregory Armstrong MD,&nbsp;Brent Weil MD, MPH,&nbsp;Bryan Dieffenbach MD,&nbsp;Rebecca M. Howell PhD, MS,&nbsp;Kevin C. Oeffinger MD,&nbsp;Paul C. Nathan MD, MSc,&nbsp;Emily S. Tonorezos MD, MPH","doi":"10.1002/cncr.35591","DOIUrl":null,"url":null,"abstract":"<div>\n \n \n <section>\n \n <h3> Introduction</h3>\n \n <p>Many childhood cancer survivors are at risk for cardiovascular disease and stroke. The North American Children's Oncology Group long-term follow-up guidelines recommend carotid ultrasound in cancer survivors 10 years after neck radiation therapy (RT) ≥40 Gy. The use of carotid ultrasound in this population has not been described.</p>\n </section>\n \n <section>\n \n <h3> Methods</h3>\n \n <p>Survivors of childhood cancer diagnosed 1970-1999 (<i>N</i> = 8693) and siblings (<i>N</i> = 1989) enrolled in the Childhood Cancer Survivor Study were asked if they had ever had a carotid ultrasound. Prevalence of carotid ultrasound was evaluated. Prevalence ratios (PR) and 95% confidence intervals (CIs) were evaluated in multivariate Poisson regression models.</p>\n </section>\n \n <section>\n \n <h3> Results</h3>\n \n <p>Among participants with no reported cardiovascular condition, prevalence of carotid ultrasound among survivors with RT ≥40 Gy to the neck (<i>N</i> = 172) was 29.7% (95% CI, 22.5–36.8), significantly higher than those with &lt;40 Gy (prevalence 10.7%; 95% CI, 9.9%–11.4%). Siblings without a cardiovascular condition (<i>N</i> = 1621) had the lowest prevalence of carotid ultrasound (4.7%; 95% CI, 3.6%–5.7%). In a multivariable models among survivors with no reported cardiovascular condition and RT ≥40 Gy to the neck, those who were over age 50 (vs. 18–49) at follow-up (PR = 1.82; 95% CI, 1.09–3.05), with a history of seeing a cancer specialist in the last 2 years (PR = 2.58; 95% CI, 1.53–4.33), or having a colonoscopy (PR = 2.02; 95% CI, 1.17–3.48) or echocardiogram (PR = 6.42; 95% CI, 1.54–26.85) were more likely to have had a carotid ultrasound.</p>\n </section>\n \n <section>\n \n <h3> Conclusion</h3>\n \n <p>Many survivors do not undergo carotid ultrasound despite meeting existing guidelines. Health care delivery features such as having seen a cancer specialist or having other testing are relevant.</p>\n </section>\n </div>","PeriodicalId":138,"journal":{"name":"Cancer","volume":"131 1","pages":""},"PeriodicalIF":6.1000,"publicationDate":"2024-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Cancer","FirstCategoryId":"3","ListUrlMain":"https://onlinelibrary.wiley.com/doi/10.1002/cncr.35591","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"ONCOLOGY","Score":null,"Total":0}
引用次数: 0

Abstract

Introduction

Many childhood cancer survivors are at risk for cardiovascular disease and stroke. The North American Children's Oncology Group long-term follow-up guidelines recommend carotid ultrasound in cancer survivors 10 years after neck radiation therapy (RT) ≥40 Gy. The use of carotid ultrasound in this population has not been described.

Methods

Survivors of childhood cancer diagnosed 1970-1999 (N = 8693) and siblings (N = 1989) enrolled in the Childhood Cancer Survivor Study were asked if they had ever had a carotid ultrasound. Prevalence of carotid ultrasound was evaluated. Prevalence ratios (PR) and 95% confidence intervals (CIs) were evaluated in multivariate Poisson regression models.

Results

Among participants with no reported cardiovascular condition, prevalence of carotid ultrasound among survivors with RT ≥40 Gy to the neck (N = 172) was 29.7% (95% CI, 22.5–36.8), significantly higher than those with <40 Gy (prevalence 10.7%; 95% CI, 9.9%–11.4%). Siblings without a cardiovascular condition (N = 1621) had the lowest prevalence of carotid ultrasound (4.7%; 95% CI, 3.6%–5.7%). In a multivariable models among survivors with no reported cardiovascular condition and RT ≥40 Gy to the neck, those who were over age 50 (vs. 18–49) at follow-up (PR = 1.82; 95% CI, 1.09–3.05), with a history of seeing a cancer specialist in the last 2 years (PR = 2.58; 95% CI, 1.53–4.33), or having a colonoscopy (PR = 2.02; 95% CI, 1.17–3.48) or echocardiogram (PR = 6.42; 95% CI, 1.54–26.85) were more likely to have had a carotid ultrasound.

Conclusion

Many survivors do not undergo carotid ultrasound despite meeting existing guidelines. Health care delivery features such as having seen a cancer specialist or having other testing are relevant.

查看原文
分享 分享
微信好友 朋友圈 QQ好友 复制链接
本刊更多论文
儿童癌症幸存者接受颈动脉超声筛查的比例:儿童癌症幸存者研究报告。
导言许多儿童癌症幸存者都有罹患心血管疾病和中风的风险。北美儿童肿瘤组织长期随访指南建议,颈部放射治疗(RT)≥40 Gy 后 10 年的癌症幸存者应进行颈动脉超声检查。颈动脉超声在这一人群中的应用尚未见报道:方法:询问1970-1999年确诊的儿童癌症幸存者(N = 8693)和参加儿童癌症幸存者研究的兄弟姐妹(N = 1989)是否接受过颈动脉超声检查。对颈动脉超声的患病率进行了评估。在多变量泊松回归模型中评估了患病率比(PR)和95%置信区间(CI):结果:在未报告心血管疾病的参与者中,颈部RT≥40 Gy的幸存者(N = 172)中颈动脉超声的患病率为29.7%(95% CI,22.5-36.8),明显高于有结论的幸存者:尽管符合现有指南,但许多幸存者并未接受颈动脉超声检查。医疗保健服务的特征(如是否看过癌症专科医生或进行过其他检查)与此有关。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
求助全文
约1分钟内获得全文 去求助
来源期刊
Cancer
Cancer 医学-肿瘤学
CiteScore
13.10
自引率
3.20%
发文量
480
审稿时长
2-3 weeks
期刊介绍: The CANCER site is a full-text, electronic implementation of CANCER, an Interdisciplinary International Journal of the American Cancer Society, and CANCER CYTOPATHOLOGY, a Journal of the American Cancer Society. CANCER publishes interdisciplinary oncologic information according to, but not limited to, the following disease sites and disciplines: blood/bone marrow; breast disease; endocrine disorders; epidemiology; gastrointestinal tract; genitourinary disease; gynecologic oncology; head and neck disease; hepatobiliary tract; integrated medicine; lung disease; medical oncology; neuro-oncology; pathology radiation oncology; translational research
期刊最新文献
Healthy diet may reduce the risk of low-grade prostate cancer progressing to a higher grade First person profile: Ronald P. DeMatteo, MD New standard of care for patients with locally advanced cervical cancer Application of artificial intelligence in the detection of Borrmann type 4 advanced gastric cancer in upper endoscopy (with video) Maintenance therapy with the FMS-like tyrosine kinase 3 inhibitor gilteritinib in patients with FMS-like tyrosine kinase 3–internal tandem duplication acute myeloid leukemia: A phase 2 study
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
现在去查看 取消
×
提示
确定
0
微信
客服QQ
Book学术公众号 扫码关注我们
反馈
×
意见反馈
请填写您的意见或建议
请填写您的手机或邮箱
已复制链接
已复制链接
快去分享给好友吧!
我知道了
×
扫码分享
扫码分享
Book学术官方微信
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术
文献互助 智能选刊 最新文献 互助须知 联系我们:info@booksci.cn
Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。
Copyright © 2023 Book学术 All rights reserved.
ghs 京公网安备 11010802042870号 京ICP备2023020795号-1