Utilization of cardiac tests in anthracycline‐treated cancer survivors differs between young adults and children: A claims‐based analysis

Abstract

Abstract Background The Children's Oncology Group Guidelines recommend a cardiacechocardiogram, or comparable functional imaging, following therapy completion in survivors of childhood/adolescent cancers exposed to anthracyclines. Methods Using the 2009–2019 Merative™ MarketScan® Commercial Database, we examined real‐world utilization of cardiac testing among 1609 anthracycline‐treated survivors of childhood/adolescent cancers. Results The cumulative incidence of receiving an initial cardiac test by 5.25 years from the index date (six months after end‐of‐therapy) was 62.3% (95% CI = 57.5%–66.7%), with median time to initial test being 2.7 years (95% CI = 2.5%–3.1%). Young adults (18–28 years) were less likely than children (≤17 years) to receive cardiac testing (hazard ratio [HR] = 0.42, 95% CI = 0.3%–0.49%). More likely to receive cardiac testing were survivors receiving hematopoietic stem cell transplantation versus chemotherapy only (HR = 2.23, 95% CI = 1.63%–3.03%), and survivors with bone or soft tissue versus hematologic cancer (HR = 1.64, 95% CI = 1.30%–2.07%). Conclusions Nearly 40% of anthracycline‐treated survivors of childhood/adolescent cancers had not received cardiac testing within 5.25 years post‐index date, with young adults least likely to receive a test.

Keywords

• anthracycline
• cardiac testing
• commercial claims data
• survivors of childhood and adolescent cancer