The landscape of cardiovascular care in pediatric cancer patients and survivors: A survey by the ACC Pediatric Cardio-Oncology Work Group

Thomas D. Ryan, William L. Border, Carissa Baker-Smith, Ana Barac, Matthew J. Bock, Mary M. Canobbio, Nadine F. Choueiter, Devyani Chowdhury, Katheryn E. Gambetta, Julie S. Glickstein, Lavanya Kondapalli, Seema Mital, Vasum Peiris, Russell J. Schiff, Robert L. Spicer, Jeffrey A. Towbin, Ming Hui Chen*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

3 Scopus citations

Abstract

Objective: To enhance the understanding of cardiovascular care delivery in childhood cancer patients and survivors. Study design: A 20-question survey was created by the Pediatric Cardio-oncology Work Group of the American College of Cardiology (ACC) Cardio-oncology Section to assess the care, management, and surveillance tools utilized to manage pediatric/young adult cardio-oncology patients. The survey distribution was a collaborative effort between Cardio-oncology Section and membership of the Adult Congenital and Pediatric Cardiology Section (ACPC) of the ACC. Results: Sixty-five individuals, all self-identified as physicians, responded to the survey. Most respondents (n = 58,89%) indicated childhood cancer patients are regularly screened prior to and during cancer therapy at their centers, predominantly by electrocardiogram (75%), standard echocardiogram (58%) and advanced echocardiogram (50%) (i.e. strain, stress echo). Evaluation by a cardiologist prior to/during therapy was reported by only 8(12%) respondents, as compared to post-therapy which was reported by 28 (43%, p < 0.01). The most common indications for referral to cardiology at pediatric centers were abnormal test results (n = 31,48%) and history of chemotherapy exposure (n = 27,42%). Of note, during post-treatment counseling, common cardiovascular risk-factors like blood pressure (31,48%), lipid control (22,34%), obesity & smoking (30,46%) and diet/exercise/weight loss (30,46%) were addressed by fewer respondents than was LV function (72%). Conclusions: The survey data demonstrates that pediatric cancer patients are being screened by EKG and/or imaging prior to/during therapy at most centers. Our data, however, highlight the potential for greater involvement of a cardiovascular specialist for pre-treatment evaluation process, and for more systematic cardiac risk factor counseling in posttreatment cancer survivors.

Original languageEnglish (US)
Article number16
JournalCardio-Oncology
Volume5
Issue number1
DOIs
StatePublished - Oct 23 2019

Keywords

  • ACC
  • Cancer
  • Cardiac risk factors
  • Cardio-oncology
  • Cardiology
  • Echocardiography
  • Pediatrics
  • Survey

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Oncology

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