| Abstract: |
Background Adult survivors of childhood cancer adhere poorly to recommended medical surveillance. We sought to identify modifiable factors that contribute to non-adherence. Methods Latent class analysis categorized survivors (ages 18-52 years) at risk of cardiac, breast, or bone late sequelae on the basis of their health-related concerns, fears, and motivation. These classifications were compared at two time points for self-reported adherence to recommended echocardiography, mammography, and bone densitometry screening. Results Three classes (worried, collaborative, and self-controlling) characterized survivors in each of the three risk groups: cardiac (N = 564; Bayesian information criterion [BIC] = 10,824.66; Lo-Mendell-Rubin parametric likelihood ratio test [LRMLRT] P =.002), breast (N = 584; BIC = 11,779.97; LRMLRT P <.001), and bone (N = 613; BIC = 11,773.56; LMRLRT P =.028). Only 9% of at-risk survivors in the self-controlling class reported undergoing bone density screening in 2005, compared with 17.2% in the collaborative class (P =.034). Thirteen percent of the self-controlling, 24% of collaborative (P =.025), and 34% of worried (P =.010) classes reported undergoing bone densitometry in 2009. Whereas 73% of at-risk survivors in the worried class reported having had an echocardiogram in 2009, only 57% of the collaborative (P =.040) and 43% of self-controlling (P <.001) classes did. In 2005 and 2009, respectively, fewer survivors in the self-controlling class (37% and 53%) than in the collaborative (51%, P =.038 and 70%, P =.01) and worried (58%, P =.002 and 69%, P =.025) classes reported undergoing mammograms. Conclusions Modifiable intrapersonal characteristics associated with these three classes predict self-reported participation in medical surveillance. Continued observation and validation of these survivor profiles may inform tailored interventions to enhance survivors' screening participation. Copyright © 2012 John Wiley & Sons, Ltd. Copyright © 2012 John Wiley & Sons, Ltd. |
