Study Finds Survivorship Care Plan Counseling Ineffective for Reducing CVD Risk in Cancer Survivors

Randomized trial shows no significant improvement in cardiovascular disease risk factor control with counseling sessions compared to screening results alone.

Published on Feb. 9, 2026

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A randomized clinical trial of 347 adult survivors of childhood cancer found that survivorship care plan-based counseling did not significantly reduce cardiovascular disease (CVD) risk factor undertreatment compared to screening results alone. After 1 year, 26% of intervention participants and 30.2% of control participants showed improved risk factor control.

Why it matters

CVD is a leading cause of morbidity and mortality in cancer survivors, particularly affecting childhood cancer survivors. The study aimed to determine if a survivorship care plan coupled with brief counseling sessions could improve control of conventional CVD risk factors among high-risk adult survivors of childhood cancer.

The details

Researchers conducted a randomized clinical trial enrolling 347 adult survivors of childhood cancer exposed to cardiotoxic therapies. Participants with undertreated CVD risk factors were randomized 1:1 to receive either a survivorship care plan with two remote counseling sessions or an enhanced care control, which involved receiving screening results and written encouragement to follow-up with their primary care clinician (PCC). Analysis included blood pressure, lipid, and glucose measurements at baseline and 1-year follow-up, with undertreatment defined by standard guidelines.

  • The study was conducted between August 2017 and April 2020, with follow-up completed by July 2022.

The players

Eric J. Chow, MD, MPH

The lead author of the study, affiliated with the Fred Hutchinson Cancer Center in Seattle.

Claire Snyder, PhD

Reported receiving grant support from Pfizer Inc, Genentech, and personal fees from Shionogi and Movember, outside the submitted work.

Karen L. Syrjala, PhD

Disclosed receiving personal fees for coauthoring chapters for UpToDate and having a patent with royalties paid.

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What they’re saying

“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.”

— Eric J. Chow, MD, MPH, Lead author (JAMA Network Open)

What’s next

The researchers suggest that additional strategies to mitigate cardiovascular disease risk in high-risk cancer survivors should be examined in future studies.

The takeaway

While the intervention group showed improved documentation of CVD risk in primary care records, the survivorship care plan-based counseling did not significantly improve control of cardiovascular disease risk factors compared to providing screening results alone to cancer survivors and their primary care clinicians.