J Korean Med Sci.  2023 Jul;38(29):e230. 10.3346/jkms.2023.38.e230.

Current Status and Physicians’ Perspectives of Childhood Cancer Survivorship in Korea: A Nationwide Survey of Pediatric Hematologists/ Oncologists

• Lee JW
• Yeo Y
• Ju HY
• Cho HW
• Yoo KH
• Sung KW
• Koo HH
• Jeong SM
• Shin DW
• Baek HJ
• Kook H
• Chung NG
• Cho B
• Kim YA
• Park HJ
• Song YM

• KMID: 2544945
• DOI: http://doi.org/10.3346/jkms.2023.38.e230

Abstract

Background
Data on the status of long-term follow-up (LTFU) care for childhood cancer survivors (CCSs) in Korea is lacking. This study was conducted to evaluate the current status of LTFU care for CCSs and relevant physicians’ perspectives.
Methods
A nationwide online survey of pediatric hematologists/oncologists in the Republic of Korea was undertaken.
Results
Overall, 47 of the 74 board-certified Korean pediatric hematologists/oncologists currently providing pediatric hematology/oncology care participated in the survey (response rate = 63.5%). Forty-five of the 47 respondents provided LTFU care for CCSs five years after the completion of primary cancer treatment. However, some of the 45 respondents provided LTFU care only for CCS with late complications or CCSs who requested LTFU care. Twenty of the 45 respondents oversaw LTFU care for adult CCSs, although pediatric hematologists/ oncologists experienced more difficulties managing adult CCSs. Many pediatric hematologists/oncologists did not perform the necessary screening test, although CCSs had risk factors for late complications, mostly because of insurance coverage issues and the lack of Korean LTFU guidelines. Regarding a desirable LTFU care system for CCSs in Korea, 27 of the 46 respondents (58.7%) answered that it is desirable to establish a multidisciplinary CCSs care system in which pediatric hematologists/oncologists and adult physicians cooperate.
Conclusion
The LTFU care system for CCS is underdeveloped in the Republic of Korea. It is urgent to establish an LTFU care system to meet the growing needs of Korean CCSs, which should include Korean CCSs care guidelines, provider education plans, the establishment of multidisciplinary care systems, and a supportive national healthcare policy.

Keyword

Childhood Cancer Survivorship; Long-term Follow-up Care; Pediatric Hematologists/Oncologists

Figure

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  Fig. 1 Current status of screening tests that detect late complications. Many pediatric hematologists/oncologists did not perform screening tests, especially breast sonography, bone mineral density tests, pulmonary function tests, dental exams, and ophthalmologic exams, even though the CCS they cared for had risk factors for each complication.CCS = childhood cancer survivor.

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  Fig. 2 Barriers to conducting screening tests. The reasons for not performing screening tests for late complications were illustrated.

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  Fig. 3 Degree of difficulties according to the age of CCS. Pediatric hematologists/oncologists experienced more difficulties when managing the older CCS group.CCS = childhood cancer survivor.

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