Identifying Patterns of Hospitalizations Among Childhood Cancer Survivors: A Population-Based Study.

Abstract

Background: Childhood cancer survivors (CCSs) experience more hospitalizations than the general population. We aimed to identify distinct hospitalization patterns among Queensland CCSs and the associated characteristics.

Methods: Cases (aged ≤14 years) diagnosed between 1995 and 2019 while residents of Queensland were identified through the Australian Childhood Cancer Registry and linked with statewide hospital admissions through December 31, 2021 or death. Survivorship was divided into four periods: 0-<3, 3-<5, 5-<10, and ≥10 years post-diagnosis. Latent class analysis identified subgroups on the basis of hospitalization frequency and reasons; demographic and clinical characteristics were compared across subgroups.

Results: Among 3252 cases (median follow-up 12 years), distinct hospitalization patterns emerged. High hospitalization rates (adjusted for person-years at risk) in the first 5 years were most common among males, younger age at diagnosis, leukemia diagnoses, and those receiving intensive treatments, such as chemotherapy and stem cell transplants. Between 5 and <10 years after diagnosis, survivors with high hospitalization rates were more likely to have experienced relapses or received stem cell transplants. Beyond 10 years, most survivors had low hospitalization rates, although a very small group (N = 17, 1%) continued to experience elevated rates of hospitalization, relapse, or death.

Conclusion: These findings highlight the need for long-term, risk-stratified follow-up care.