BETHESDA, MD — Does universal access to healthcare make any difference in health screening for pediatric acute lymphoblastic leukemia (ALL) survivors?
That was the question researchers from the Walter Reed National Military Medical Center and colleagues sought to answer.
The number of children who survived ALL is growing, and those patients have unique health screening needs within late effects oncology and primary care clinics, according to the report in Military Medicine.
“Prior attempts to quantify compliance with follow-up recommendations have shown variable rates ranging from 28% to 73%,” the authors wrote, adding that their study was designed to assess rates of adherence to recommended health screening among pediatric ALL survivors within the DoD’s healthcare .S. DoD, identify potential risk factors contributing to patient compliance, and better define the prevalence of chronic health conditions.
The retrospective cohort study used data from the MHS database and identified incident cases of pediatric ALL during 2007-2011 using a conservative case identification algorithm. Overall, 144 incident ALL cases were identified.
Researchers reported that, during the follow-up period, 31.3% developed a new mental health diagnosis. In terms of recommended screening, 94.4% had an annual complete blood count for the entire study period, 90.3% had a liver function screening, 81.9% had an echocardiogram, 34% had a bone density scan, and 54.2% had a mental health visit.
They advised that adolescents were less likely to have a bone density scan (odds ratio [OR] 0.32, 95% CI, 0.11-0.95) or a mental health visit (OR 0.28, 95% CI, 0.11-0.7) than other age groups.
“The MHS provides universal access to healthcare for all beneficiaries. In this population with universal access to care, there is increased compliance with screening recommendations,” the authors concluded. “Our results reflect actual screening testing as opposed to general screening visits that have been previously reported in the literature. We also highlight the significant number of mental health diagnoses among pediatric ALL survivors.”
- Zanetti R, Warwick A, Sicignano N, Feldman B. Late Effects Screening of Acute Lymphoblastic Leukemia Survivors in the Military Healthcare System. Mil Med. 2022 Mar 21:usac069. doi: 10.1093/milmed/usac069. Epub ahead of print. PMID: 35312003.
