Transition practices for survivors of childhood cancer: a report from the Children’s Oncology Group

Jordan Gilleland Marchak, Karim T. Sadak, Karen E. Effinger, Regine Haardörfer, Cam Escoffery, Karen E. Kinahan, David R. Freyer, Eric J. Chow, Ann Mertens

Research output: Contribution to journalArticlepeer-review

4 Scopus citations


Purpose: Pediatric healthcare systems must support childhood cancer survivors to optimize their transition to adult care. This study aimed to assess the state of healthcare transition services provided by Children’s Oncology Group (COG) institutions. Methods: A 190-question online survey was distributed to 209 COG institutions to assess survivor services, including transition practices, barriers, and implementation of services aligned with the six core elements of Health Care Transition 2.0 from the US Center for Health Care Transition Improvement. Results: Representatives from 137 COG sites reported on institutional transition practices. Two-thirds (66.4%) of site discharge survivors to another institution for cancer-related follow-up care in adulthood. Transfer to primary care (33.6%) was a commonly reported model of care for young adult-aged survivors. Site transfer at ≤ 18 years (8.0%), ≤ 21 years (13.1%), ≤ 25 years (7.3%), ≥ 26 years (12.4%), or when survivors are "ready" (25.5%). Few institutions reported offering services aligned with the structured transition process from the six core elements (Median = 1, Mean = 1.56, SD = 1.54, range: 0–5). The most prevalent barriers to transitioning survivors to adult care were perceived lack of late-effects knowledge among clinicians (39.6%) and perceived lack of survivor desire to transfer care (31.9%). Conclusions: Most COG institutions transfer adult-aged survivors of childhood cancer elsewhere for survivor care, yet few programs report delivering recognized standards for quality healthcare transition programming to support survivors. Implications for Cancer Survivors: Development of best practices for survivor transition is needed to help promote increased early detection and treatment of late effects among adult survivors of childhood cancer.

Original languageEnglish (US)
Pages (from-to)342-350
Number of pages9
JournalJournal of Cancer Survivorship
Issue number2
StatePublished - Apr 2023

Bibliographical note

Funding Information:
Research reported in this publication was supported by the Children’s Oncology Group Outcomes and Survivorship, Adolescent and Young Adult, and Nursing Committees, the National Cancer Institute under Award Numbers R01CA218389, U10CA180886, and UG1CA189955, and the Intervention Development, Dissemination, and Implementation Developing shared resource of Winship Cancer Institute of Emory University and NIH/NCI under award number P30CA138292.

Publisher Copyright:
© 2023, The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.


  • Late effects services
  • Pediatric cancer
  • Survivorship
  • Transition to adult care

PubMed: MeSH publication types

  • Journal Article
  • Research Support, Non-U.S. Gov't
  • Research Support, N.I.H., Extramural


Dive into the research topics of 'Transition practices for survivors of childhood cancer: a report from the Children’s Oncology Group'. Together they form a unique fingerprint.

Cite this