{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T14:08:59Z","timestamp":1786975739881,"version":"build-2736575974"},"reference-count":44,"publisher":"American Medical Association (AMA)","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAMA Netw Open"],"abstract":"\n Importance<\/jats:title>\n Survivors of childhood cancer have an increased risk of cardiovascular disease (CVD). However, many survivors at high risk do not receive recommended CVD screening tests as young adults.<\/jats:p>\n <\/jats:sec>\n \n Objective<\/jats:title>\n To assess whether a survivorship care plan (SCP)\u2013based counseling intervention improves CVD risk factor control in high-risk survivors.<\/jats:p>\n <\/jats:sec>\n \n Design, Setting, and Participants<\/jats:title>\n The Communicating Health Information and Improving Coordination With Primary Care (CHIIP) Study was a randomized clinical trial that enrolled eligible participants from the Childhood Cancer Survivor Study cohort in 9 US metropolitan areas between August 2017 and April 2020, with follow-up completed July 2022. Participants included adult survivors of childhood cancer exposed to cardiotoxic cancer therapies with undertreated CVD risk factors (hypertension, dyslipidemia, and glucose intolerance defined by standard guidelines); of 1840 survivors approached, 842 consented to participate, and 347 met all eligibility requirements and were randomized after a baseline home assessment. Data analysis was completed March 18, 2025.<\/jats:p>\n <\/jats:sec>\n \n Intervention<\/jats:title>\n The intervention consisted of a single remote session to review measurements and a SCP with personalized CVD risk information and to develop a CVD risk factor management plan, with a booster session 4 months later. Enhanced care controls received measurements with abnormal findings noted and written encouragement to follow up with their primary care clinician (PCC). PCCs received all materials sent to participants.<\/jats:p>\n <\/jats:sec>\n \n Main Outcomes and Measures<\/jats:title>\n \n Blood pressure, lipid profile, and glucose and hemoglobin A\n 1c<\/jats:sub>\n levels collected by a trained home examiner at baseline and 1-year follow-up, with undertreatment defined by standard guidelines.\n <\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n A total of 347 cancer survivors (mean [SD] age, 40.5 [9.4] years; 182 [52.4%] male) were randomized, 175 to the intervention group and 172 to the enhanced care control group. Of these, 194 participants (53.0%) participants had undertreated hypertension at baseline; 180 (51.9%), undertreated dyslipidemia; and 170 (49.0%) undertreated glucose intolerance. After 1 year, 45 of 173 surviving intervention participants (26.0%) and 52 of 172 enhanced care control participants (30.2%) had less undertreatment, with lower percentages for each condition vs baseline. Although the intervention did not reduce undertreatment compared with the control condition (odds ratio, 1.31; 95% CI, 0.84-2.05), greater engagement was associated with less undertreatment at 1 year among intervention participants (odds ratio, 0.31; 95% CI, 0.18-0.72). The intervention group had improved PCC documentation of CVD risk vs controls after 1 year (14.8% improvement vs 0.9%;\n P<\/jats:italic>\n \u2009=\u2009.002).\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions and Relevance<\/jats:title>\n In this randomized clinical trial of long-term survivors of childhood cancer, the addition of survivorship-based self-management counseling did not reduce undertreatment beyond simply providing CVD risk assessments to survivors and PCCs. Additional strategies to mitigate CVD risk in high-risk survivors should be examined in the future.<\/jats:p>\n <\/jats:sec>\n \n Trial Registration<\/jats:title>\n \n ClinicalTrials.gov Identifier:\n NCT03104543<\/jats:ext-link>\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1001\/jamanetworkopen.2025.55863","type":"journal-article","created":{"date-parts":[[2026,2,5]],"date-time":"2026-02-05T16:30:29Z","timestamp":1770309029000},"page":"e2555863","source":"Crossref","is-referenced-by-count":3,"title":["Counseling and Cardiovascular Disease Risk Factor Control in Long-Term Cancer Survivors"],"prefix":"10.1001","volume":"9","author":[{"given":"Eric J.","family":"Chow","sequence":"first","affiliation":[{"name":"Fred Hutchinson Cancer Center, Seattle, Washington"},{"name":"University of Washington, Seattle"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yan","family":"Chen","sequence":"additional","affiliation":[{"name":"St Jude Children\u2019s Research Hospital, Memphis, Tennessee"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yutaka","family":"Yasui","sequence":"additional","affiliation":[{"name":"St Jude Children\u2019s Research Hospital, Memphis, Tennessee"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura-Mae","family":"Baldwin","sequence":"additional","affiliation":[{"name":"University of Washington, Seattle"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Melissa M.","family":"Hudson","sequence":"additional","affiliation":[{"name":"St Jude Children\u2019s Research Hospital, Memphis, Tennessee"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tammy M.","family":"Muller","sequence":"additional","affiliation":[{"name":"Fred Hutchinson Cancer Center, Seattle, Washington"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paul C.","family":"Nathan","sequence":"additional","affiliation":[{"name":"Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Siu L.","family":"Ngai","sequence":"additional","affiliation":[{"name":"University of Washington, Seattle"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Timothy J. 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