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Health Care Utilization by Adult Long-term Survivors of Hematopoietic Cell Transplant: Report from the Bone Marrow Transplant Survivor Study

¹ Vanderbilt-Ingram Cancer Center, Nashville, Tennessee; ² City of Hope Cancer Center, Duarte, California; ³ University of Minnesota, Minneapolis, Minnesota; ⁴ University of Michigan, Ann Arbor, Michigan; and ⁵ St. Jude Children's Research Hospital, Memphis, Tennessee

Requests for reprints: Smita Bhatia, City of Hope Cancer Center, 1500, East Duarte Road, Duarte, CA 91010-3000. Phone: 626-301-8426; Fax: 626-301-8978. E-mail: sbhatia{at}coh.org

The high intensity of therapy and prolonged immune suppression after hematopoietic cell transplantation (HCT) increase the risk of long-term complications and health care needs among survivors. The aim of this study was to evaluate the current status of health care utilization by long-term HCT survivors and to identify factors associated with lack of utilization. A total of 845 individuals who had undergone HCT between 1974 and 1998 at age 21 years or older and survived 2 or more years after HCT participated in the study. Health care utilization was assessed through a mailed questionnaire in three domains: general contact with health care system, general physical examination, and cancer/HCT–related visit. The median age at HCT was 38.2 years, and the median length of follow-up was 6.4 years. Overall, 98% of allogeneic and 94% of autologous HCT survivors reported medical contact 11+ years after HCT. Cancer/HCT–related visits decreased with increasing time from HCT (allogeneic HCT, 98-57%; autologous HCT, 94-63%). The prevalence of general physical examination increased with time (allogeneic HCT, 56-74%; autologous HCT, 72-81%). Primary care physicians provide health care for an increasing number of adult long-term survivors of HCT, emphasizing the need for increased awareness of the long-term follow-up needs of the HCT survivors by the health care providers. (Cancer Epidemiol Biomarkers Prev 2007;16(4):834–9)