Ambulant health care utilisation among children of childhood cancer survivors in Germany

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Within the framework of a questionnaire-based health survey in Germany, we examined ambulant health care utilisation among childhood cancer survivors’ offspring compared to utilisation among children of the general population.


In total, 1299 former patients received a questionnaire for every known biological child in two cross-sectional surveys, 2013/14 (n = 393) and 2015/16 (n = 906). For investigation of health care utilisation, questions on frequencies and kind of ambulant medical services were chosen for bivariate and multivariate analyses. Correlations between utilisation and anxiety, diagnosis of the parent, pain or preterm birth of the child and social indicators were conducted. For comparison with the general population, data of 17,640 children and adolescents aged 0 to 17 years were used for matched-pair analysis. These data were available from the KIGGS baseline study on the health of children and adolescents in Germany, conducted by the Robert Koch Institute.


Overall, 852 (65.6%) of the contacted 1299 survivors completed 1340 questionnaires on their children’s health. Childhood cancer survivors’ offspring showed a similar attendance of ambulant primary health care compared to the general population (paediatricians 83.1% vs. 82.1%). However, the majority of specialist physicians was visited significantly more often (e.g. dermatologist 10.5% vs. 6.2%) by childhood cancer survivors’ offspring compared to children from the general population. Logistic regression showed that parental diagnosis and anxiety on children’s health significantly influenced health care utilisation.


Further improvement of after-care for childhood cancer survivors by including topics on offspring seems necessary. Offspring’s paediatricians should implement counselling and providing of information considering the special family anamnesis.

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Fig. 1



Childhood cancer survivor


Ear, nose and throat physician


German Childhood Cancer Registry


Society for Paediatric Oncology and Haematology


Hospitalisation rate risk


German Health Interview and Examination Survey for Children and Adolescents


Robert Koch Institute


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We thank all participants in our Multicentre Offspring Study for participation, as well as the Robert-Koch Institute, the VIVE study and the German Childhood Cancer Registry for the good cooperation.


The Multicentre Offspring Study was supported by the Madeleine Schickedanz Kinderkrebsstiftung, KINDerLEBEN e.V. Berlin, the Junior Clinician-Scientist Program (Charité–Universitätsmedizin Berlin and Berlin Institute of Health) and with a doctoral grant from the José Carreras Leukämie-Stiftung.

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Correspondence to Anja Borgmann-Staudt.

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The authors declare that they have no conflict of interest.

Mrs. Borgmann-Staudt, Mrs. Balcerek, Mrs. Schuster and Mr. Schilling were supported by nonprofit organisations for accomplishment of the study. The authors have full control of primary data and would allow review of the data if requested.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Informed consent was obtained from all individual participants included in the study.

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Schuster, T., Korte, E., Schilling, R. et al. Ambulant health care utilisation among children of childhood cancer survivors in Germany. Support Care Cancer 28, 787–795 (2020) doi:10.1007/s00520-019-04861-7

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  • Childhood cancer survivors
  • Cancer survivor’s offspring
  • Ambulant health care utilisation
  • Anxiety