Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2023 Sep;12(17):18281-18305.
doi: 10.1002/cam4.6426. Epub 2023 Aug 8.

Disparities in pediatric cancer survivorship care: A systematic review

Erin M Mobley  1 , Diana J Moke  2   3   4 , Joel Milam  4   5 , Carol Y Ochoa-Dominguez  6 , Julia Stal  4   7 , Halle Mitchell  1 , Naghmeh Aminzadeh  8 , Maria Bolshakova  8 , Raymond B Mailhot Vega  9 , Jennifer Dinalo  8 , Aneesa Motala  8 , Susanne Hempel  8
Affiliations

Disparities in pediatric cancer survivorship care: A systematic review

Erin M Mobley et al. Cancer Med. 2023 Sep.

Abstract

Background: Childhood cancer survivors (CCS) experience many long-term health problems that can be mitigated with recommended survivorship care. However, many CCS do not have access to survivorship care nor receive recommended survivorship care. We reviewed the empirical evidence of disparities in survivorship care for CCS.

Methods: This systematic review searched PubMed, CINAHL, and PsycINFO for studies on survivorship care for CCS (PROSPERO: CRD42021227965) and abstracted the reported presence or absence of disparities in care. We screened 7945 citations, and of those, we reviewed 2760 publications at full text.

Results: A total of 22 studies reported in 61 publications met inclusion criteria. Potential disparities by cancer treatment (N = 14), diagnosis (N = 13), sex (N = 13), and current age (N = 13) were frequently studied. There was high quality of evidence (QOE) of survivorship care disparities associated with non-White race, Hispanic ethnicity, and being uninsured. Moderate QOE demonstrated disparities among CCS who were unemployed and older. Lower QOE was found for disparities based on cancer diagnosis, cancer treatment, age at diagnosis, time since diagnosis, sex, insurance type, income, educational attainment, and geographic area.

Conclusions: We found strong empirical evidence of disparities in survivorship care for CCS associated with race, ethnicity, and insurance status. Multiple other disparate groups, such as those by employment, income, insurance type, education, cancer diagnosis, age at diagnosis, time since diagnosis, cancer treatment, geographic area, sex, and self-identified gender warrant further investigation. Prospective, multilevel research is needed to examine the role of other patient characteristics as potential disparities hindering adequate survivorship care in CCS.

Keywords: cancer survivors; health equity; health services accessibility; healthcare disparities.

PubMed Disclaimer

Conflict of interest statement

None of the authors have any affiliations or financial involvement that conflicts with the material presented in this manuscript.

Figures

FIGURE 1
FIGURE 1
PRISMA flow diagram.
FIGURE 2
FIGURE 2
Variables mapped to survivorship care disparities by quality of evidence and number of studies.
FIGURE 3
FIGURE 3
Risk of bias.
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

References

    1. Robison LL, Hudson MM. Survivors of childhood and adolescent cancer: life‐long risks and responsibilities. Nat Rev Cancer. 2014;14(1):61‐70. doi:10.1038/nrc3634 - DOI - PMC - PubMed
    1. American Cancer Society . Cancer Facts and Figures 2023 . 2023.
    1. National Research Council . Childhood Cancer Survivorship: Improving Care and Quality of Life. The National Academies Press; 2003. - PubMed
    1. Kirchhoff A, Leisenring W, Krull K, et al. Unemployment among adult survivors of childhood cancer: a report from the childhood cancer survivor study. Med Care. 2010;48(11):1015‐1025. - PMC - PubMed
    1. Gurney JG, Krull KR, Kadan‐Lottick NS, et al. Social outcomes in the childhood cancer survivor study cohort. J Clin Oncol. 2009;27(14):2390‐2395. - PMC - PubMed

Publication types