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Non-oncology physician visits after diagnosis of cancer in adolescents and young adults



Health care needs of adolescents and young adults (AYAs) with cancer are probably different from other age groups. Studying their non-oncology physician visits in the first years after diagnosis may provide insight into the specific health problems AYA patients experience and thereby help to improve care for these patients.


Seven hundred seventy-four AYAs identified from a Canadian provincial registry diagnosed with cancer between ages 15 and 24 years in 1991/2001 were included, matched by birth year and sex to ten controls. Based on provincial health insurance plan records, we determined the number of family physician and non-cancer specialist visits in the 5 years after diagnosis (for patients) or inclusion (for controls).


The percentage of patients visiting a non-cancer specialist decreased from 96 to 49 % over the 5-year period. The percentage visiting a family physician decreased from 96 to 84 %. Visits in all years were significantly higher than among controls. In the first year after diagnosis, many patients visited a non-cancer specialist or a family physician for neoplasm-related health problems (77 and 55 %, respectively). In addition, family physicians were also consulted for general age-specific problems, such as genitourinary symptoms


In the first years after diagnosis of cancer in AYAs, both non-cancer specialist and family physician visits are common, although non-cancer specialist visits are less common and decline considerably faster than in younger children.

Implications for Cancer Survivors

The specific pattern of physician visits of this age group calls for care that is tailored to their specific needs.

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Correspondence to Marianne J. Heins.

Ethics declarations


Funding for this study was received from the Canadian Institutes of Health Research, the Canadian Cancer Society (through the National Cancer Institute of Canada), and the Dutch Cancer Society.

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards and Canadian legislation on privacy. BC Cancer Agency (BCCA) and BC Children’s Hospital (BCCH) clinical Research Ethics Boards, both part of the University of British Columbia Research Ethics Board, approved of the study. BC Cancer Agency, BC Children’s Hospital, and BC Ministry of Health approved access to and use of the data, facilitated by Population Data BC, for this study.

Informed consent

Given the large number of participants, obtaining individual informed consent was not feasible. To protect patient confidentiality, only de-identified linked files were available to the researchers and the Ministry of Health required suppression of cells with fewer than five patients in the text and tables.

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Heins, M.J., Lorenzi, M.F., Korevaar, J.C. et al. Non-oncology physician visits after diagnosis of cancer in adolescents and young adults. J Cancer Surviv 10, 783–788 (2016).

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  • Neoplasms
  • Adolescent
  • Primary health care
  • Lymphoma
  • Neoplasms, germ cell, and embryonal
  • Adolescent health services