Poster Presentation Clinical Oncology Society of Australia Annual Scientific Meeting 2026

Factors influencing engagement with personalised survivorship recommendations in childhood cancer survivors (145523)

Rachel E Houweling 1 2 , Jordana K McLoone 1 2 , Claire E Wakefield 1 2 , Joseph Alchin 1 2 , Elysia Thornton-Benko 2 3 4 , Karen A Johnston 1 2 , Rachael Baldwin 1 2 , Adam Nelson 1 2 , Dinisha Govender 5 6 , Kristen Neville 1 2 , Richard Cohn 1 2 , Christina Signorelli 1 2
  1. 1. Behavioural Sciences Unit, Discipline of Paediatrics & Child Health, School of Clinical Medicine, Randwick Clinical Campus, UNSW Medicine & Health,, UNSW Sydney, Sydney, Australia, Pyrmont, Australia
  2. 2. Minderoo Children's Comprehensive Cancer Centre, Sydney Children's Hospital, , Randwick, NSW, Australia
  3. Bondi Rd Doctors, Bondi, NSW, Australia
  4. 3. Bondi Road Doctors, Bondi, NSW, Australia
  5. 4. Cancer Centre for Children, The Children's Hospital at Westmead, Westmead, NSW, Australia
  6. Cancer Centre for Children, The Children's Hospital at Westmead, Westmead, NSW, Australia

Aims

Childhood cancer survivors are at risk of chronic poor health outcomes but adherence to healthcare recommendations is low. This study explored factors which influence the likelihood of childhood cancer survivors adhering to the personalised healthcare recommendations delivered during ‘Engage’ - a multi-disciplinary survivorship intervention.

Methods

Australian childhood cancer survivors (diagnosed < 18 years, ≥5 years post-diagnosis, in remission, and >2 years from last specialist appointment) completed a remote, guideline-informed health and lifestyle assessment and nurse consultation. A Sydney-based multidisciplinary team reviewed the survivors’ clinical history, current health concerns and psychosocial needs, and provided personalised survivorship care recommendations. We used hierarchical linear regression with linear and quadratic-terms and a binomial generalized linear model to compare recommended versus completed behaviours (adherence) across clinical (e.g. treatment) and demographic (e.g. age) factors, at 1-, 6-, and 12-months post-intervention.

Results

Adherence data were analysed for 105 survivors (mean age at diagnosis: 7.4 years; mean time since diagnosis: 18 years; 31.4% High Grade Brain Tumours). Survivors received a mean of 6.9 recommendations (range: 2–14) and adhered to a mean of 3.4 (range: 0–11; mean individual adherence rate = 53.3%). Adherence increased linearly with recommendation burden (ΔR²=.194, β=.457, p<.001). There was no evidence of a ‘tipping point’ (ΔR²=.004, p=.509). Lower adherence was associated with multimodal cancer therapy rather than surgery alone (OR=0.57, 95%CI=0.36–0.89, p=.014) and not having private health insurance (OR=0.68, 95%CI=0.50–0.94, p=.019). Higher adherence was associated with female sex (OR=1.42, 95%CI=1.04–1.94, p=.028).

Conclusions

Adherence to survivorship care recommendations was low, but influenced less by the volume of recommendations than by certain clinical (i.e. receipt of multimodal therapy) and individual characteristics (female sex, insurance). Support for childhood cancer survivors to address barriers in adhering to healthcare recommendations should be tailored for their personal needs and circumstances.