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Understanding Long-Term Cancer Survivors' Preferences for Ongoing Medical Care.

ABSTRACT: BACKGROUND:Due to risk for treatment-related late effects and concerns about cancer recurrence, long-term cancer survivors have unique medical needs. Survivors' preferences for care may influence adherence and care utilization. OBJECTIVE:To describe survivors' preferences for care and factors associated with preferred and actual care. DESIGN:Cross-sectional analysis of participants in a longitudinal study using mailed questionnaires. PARTICIPANTS:Survivors of ten common cancers (n?=?2,107, mean years from diagnosis 8.9). MAIN MEASURES:(1) Survivors' preferences for primary care physician (PCP) and oncologist responsibilities across four types of care: cancer follow-up, cancer screening, preventive health, and comorbid conditions. (2) Survivor-reported visits to PCPs and oncologists. KEY RESULTS:The response rate was 42.1%. Most long-term survivors preferred PCPs and oncologists share care for cancer follow-up (63%) and subsequent screening (65%), while preferring PCP-led preventive health (77%) and comorbid condition (83%) care. Most survivors (88%) preferred oncologists involved in cancer follow-up care, but only 60% reported an oncologist visit in the previous 4 years, and 96% reported a PCP visit in the previous 4 years. In multivariable regressions, those with higher fear of cancer recurrence were less likely to prefer PCP-led cancer follow-up care (OR?=?0.96, CI?=?0.93-0.98), as did survivors with advanced cancer stage (OR?=?0.56, CI?=?0.39-0.79). Those with higher fear of recurrence (OR?=?1.03, CI?=?1.01-1.04) or who preferred oncologist-led cancer follow-up care (OR?=?2.08, CI?=?1.63-2.65) had greater odds of seeing an oncologist in the last 4 years. CONCLUSIONS:Most cancer survivors preferred PCPs and oncologists share care for cancer follow-up and screening, yet many had not seen an oncologist recently. Survivors preferred PCP-led care for other preventive services and management of comorbid conditions. These findings highlight the important role PCPs could play in survivor care, suggesting the need for PCP-oriented education and health system policies that support high-quality PCP-led survivor care.

SUBMITTER: Smith TG

PROVIDER: S-EPMC6816669 | biostudies-literature | 2019 Oct

REPOSITORIES: biostudies-literature

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Understanding Long-Term Cancer Survivors' Preferences for Ongoing Medical Care.

Smith Tenbroeck G TG Strollo Sara S Hu Xin X Earle Craig C CC Leach Corinne R CR Nekhlyudov Larissa L

Journal of general internal medicine 20190731 10

<h4>Background</h4>Due to risk for treatment-related late effects and concerns about cancer recurrence, long-term cancer survivors have unique medical needs. Survivors' preferences for care may influence adherence and care utilization.<h4>Objective</h4>To describe survivors' preferences for care and factors associated with preferred and actual care.<h4>Design</h4>Cross-sectional analysis of participants in a longitudinal study using mailed questionnaires.<h4>Participants</h4>Survivors of ten com ...[more]

PMID: 31367870

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Understanding Long-Term Cancer Survivors' Preferences for Ongoing Medical Care.

Publications

Understanding Long-Term Cancer Survivors' Preferences for Ongoing Medical Care.

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