Pathways of care for adolescent patients with cancer in France from 2006 to 2007

Pediatr Blood Cancer. 2012 Jun;58(6):924-9. doi: 10.1002/pbc.24032. Epub 2011 Dec 16.

Abstract

Background: In France, as in other countries, there is a need for a population-based view of access to care and modalities of treatment for adolescents with cancer.

Procedure: Using a population-based registration, we report pathways of care for 15-19-year-old patients, diagnosed with cancer in 2006 and 2007, living in six French regions, accounting for 41% of the French population.

Results: The median times (inter-quartile range) for diagnosis and treatment of the 594 included adolescents were 8 weeks (3-17) and 3 days (0-16), respectively. First physicians met by the patients were mostly general practitioners (59%). Seventeen percent of patients were firstly seen on emergency wards. Most of the patients (82%) were treated in an adult environment. Management decisions were taken within the context of a multi-disciplinary team (MDT) in 54% of cases. Twenty-seven percent of patients were included in randomized or non-randomized clinical studies: percentage depended on the tumor type and on the number of on-going trials at the study period. Fifteen percent of patients were included in pediatric studies, 7% in adult studies, and 5% in studies including both adults and children.

Conclusions: The pathways of care for French adolescent patients with cancer are heterogeneous. Our results reveal differences in MDT meetings according to tumor types and a lack of effective collaboration between pediatric and adult wards. Efforts must be made to develop cancer networks to ensure that adolescents receive the optimal care in a suitable environment.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Clinical Trials as Topic
  • Female
  • France
  • Health Services Accessibility / statistics & numerical data*
  • Hematology / statistics & numerical data
  • Hospitals, University / statistics & numerical data
  • Humans
  • Male
  • Medical Oncology / statistics & numerical data
  • Neoplasms / diagnosis*
  • Neoplasms / therapy*
  • Pediatrics / statistics & numerical data
  • Physicians / statistics & numerical data
  • Referral and Consultation / statistics & numerical data
  • Young Adult