Discussion
anthracycline-associated cardiomyopathy, ’ cancer, cardiovascular disease, cardiomyopathy
CARDIOVASCULAR DISEASE, CHILDHOOD CANCER, DISEASE, CARDIOMYOPATHY, PCP
In this cross-sectional study of the PCP-documented screening patterns of a cohort of survivors of childhood cancer at high risk for cardiovascular disease, we found that adherence to regular cardiovascular screening was suboptimal. Few PCP records mentioned items pertinent to survivors’ cancer histories or a need for late-effects surveillance. Almost one-third of evaluable participants had no documentation acknowledging a history of childhood cancer. Furthermore, concordance between participant self-report and PCP records, compared with known exposures abstracted from original oncology treatment records, varied considerably but was often poor. Only 21.5% of these individuals at elevated risk of cardiovascular disease had recommended echocardiography planned or performed in the prior 2 years. This was similar to the rate identified from an earlier CCSS intervention study focused on enhancing cardiomyopathy screening.Although several prior studies have raised concerns for suboptimal screening for multiple conditions among survivors of childhood cancer,Although the overall adherence to cardiovascular screening recommendations among this selected population is disconcerting, our findings provide hope that streamlined communication between oncologists, patients, and primary care could improve awareness, adherence, and overall cardiovascular outcomes. As strategies emerge to prevent or treat anthracycline-associated cardiomyopathy, either through the reduction of modifiable disease risk factors or cardiac remodeling as heart function begins to worsen,