ArticleBMJ global health2025
Mapping of current resources and models of care for paediatric cancer survivors in Asia: a multinational survey.
Article in BMJ global health, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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20 authors.
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Abstract
introductionPaediatric cancer survivorship is an emerging priority in the current global health agenda. The models of long-term follow-up (LTFU) in Asia may vary widely based on differences in healthcare systems and resources. This study aims to characterise the models of care and current resources available for paediatric cancer survivors in Asian countries.
methodsThis multinational, cross-sectional study conducted from February to May 2024 recruited clinicians practising in an institution/centre in the United Nations geoscheme, using a combination of purposive and snowball sampling. They were identified through the 18th St Jude-Viva Forum in Singapore and local professional societies. Each invited institution nominated a representative to complete a structured questionnaire focusing on the institution's characteristics of LTFU care, the availability of risk-based screening tests according to the Children's Oncology Long-term Follow-up Guideline and the availability of recommended services in an LTFU programme.
resultsThe survey included participants representing 87 paediatric oncology units/institutions from 28 Asian countries/regions (response rate 68%). Out of the 87 units/institutions, the majority of institutions provided LTFU care through specialised LTFU clinics (44%) or oncologist-led clinics (45%). Significantly more institutions with specialised LTFU clinics offered assessments by multidisciplinary professionals, for example, motor (74% vs 44%, p=0.008) and speech/language (66% vs 36%, p=0.008) assessments, than those adopting other models of care. Institutions with LTFU clinics were more likely to provide health risk counselling (p=0.045), fertility preservation (p=0.018), pain clinics (p=0.008) and nutrition programmes (p=0.018). Institutions adhering to a specific LTFU guideline were more likely to provide comprehensive visual assessment (p=0.012) and health risk counselling (p<0.001). There were no differences between the economies in providing basic late-effects screening tests.
conclusionOur findings demonstrated that establishing an LTFU clinic according to evidence-based guidelines can facilitate more comprehensive late-effects screening and support for survivors. Regional collaborations should aim to develop resources-stratified recommendations and policies for coordinated and integrated LTFU care in Asian countries.
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