Characterising childhood cancer survivors in Germany: A retrospective observational study on demographic, clinical, and healthcare utilisation patterns
Year: 2025
Type: article
Study design: Observational Study
Abstract: Background As survival rates for childhood cancer improve, understanding long-term outcomes and healthcare needs of childhood cancer survivors (CCS) is essential. In Germany, such data have been limited. Objective This study aimed to describe demographic and clinical characteristics of a long-term CCS cohort and assess healthcare utilisation patterns based on cancer registry and statutory health insurance (SHI) claims data. Methods The VersKiK study linked GCCR data with claims from 13 SHI providers, covering 69% of the German statutorily insured population. The analysis of healthcare utilisation included 11,863 CCS diagnosed since 1991-2011, known to be alive in 01/2017 and maintained uninterrupted statutory health insurance coverage during 2017-2021.Healthcare utilisation was compared to a 1:3-matched comparison group (matching factors insurance duration, sex, birth year, and region). Results Long-term CCS had significantly higher healthcare utilisation across all metrics. They experienced 1.1 to 5.1 times more outpatient visits, hospital stays, medication prescriptions, and episodes of work incapacity than the control group. Utilisation varied considerably by cancer type, age at diagnosis, sex, and region. Survivors of CNS tumours, bone tumours, and soft tissue sarcomas showed the highest service use. Differences in utilisation between survivors and controls were greater among younger than older survivors. Conclusions This large, population-based record linkage study highlights significant differences in healthcare use between CCS and the general population, emphasising the need for evidence-based policies and tailored clinical care models. Further detailed analyses of claims data in this context can guide improvements in long-term care access, coordination, and outcomes for survivors.
Source: EJC Paediatric Oncology
Authors: Ekaterina Aleshchenko, Pietro Trocchi, Christian Apfelbacher, Katja Baust, Gabriele Calaminus, Patrik Droege, Dirk Horenkamp-Sonntag, Peter Ihle, Melanie Klein, Jutta Kuepper-Nybelen, Thorsten Langer, Christian Luepkes, Ursula Marschall, Hiltrud Merzenich, Thomas Ruhnke, Claudia Spix, Enno Swart, Cecile Ronckers
Institutions: Otto-von-Guericke-Universität Magdeburg, University Hospital Bonn, Wissenschaftliches Institut der AOK, Techniker Krankenkasse (Germany), University of Cologne, DAK-Gesundheit (Germany), University Hospital Schleswig-Holstein, Oldenburger Institut für Informatik, BARMER GEK, Johannes Gutenberg University Mainz, University Medical Center of the Johannes Gutenberg University Mainz, German Cancer Research Center
Language: English
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $2,340
Funder: Gemeinsame Bundesausschuss
Award: G6593223768
OpenAlex ID: W7106843936