Cancer survivors in the U.S. often lack discussions with their providers about survivorship care, but a new study suggests that physician training and improved coordination between providers could boost these talks about follow-up care.
Patients who survive cancer have fought and won a difficult battle. But now, a new study, based on a national survey, finds that cancer survivors don’t receive much direction from oncologists and primary care providers as they embark on the next phase of their care.
According to the National Cancer Institute (NCI), as of January 2012, it is estimated that there are 13.7 million cancer survivors in the U.S. This represents approximately 4 percent of the population. Sixty-four percent of survivors have survived five years or more; 40 percent have survived 10 years or more; and 15 percent have survived 20 years or more after diagnosis. Fifty-nine percent of survivors are currently 65 years of age and older.
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By 2022, the number of cancer survivors is projected to increase by 31 percent, to almost 18 million, which represents an increase of more than 4 million survivors in 10 years. Over the next decade, the number of people who have lived five years or more after their cancer diagnosis is projected to increase approximately 37 percent, to 11.9 million.
The new study used data from the Survey of Physicians’ Attitudes Regarding the Care of Cancer Survivors (SPARCCS) about practices and attitudes regarding post-treatment follow-up care for breast and colon cancer survivors. The study consisted of a nationally representative sample of 1,130 oncologists and 1,020 Primary Care Providers (PCPs), who were asked about survivorship care practices with survivors.
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The survey, published in the Journal of Clinical Oncology, found that although 64 percent of the oncologists mentioned that they always, or almost always discuss survivorship care recommendations with patients, fewer respondents, (32 percent) discussed who survivors should see for cancer-related and other follow-up care.
What’s more, less than five percent of oncologist respondents also provided a written Survivorship Care Plan (SCP) to the survivor.
Noting that survivorship care planning should involve discussions between providers and cancer survivors to address survivors’ needs and optimize adherence, the researchers stated, “Survivorship care recommendations and provider responsibility were not regularly discussed by PCPs and survivors. Twelve percent of the primary care providers surveyed said they had regular discussions about recommendations for survivorship care or provider responsibility.”
According to the study, oncologists who reported detailed training about late and long-term effects of cancer were more likely to provide written SCPs, and discuss survivorship care planning with survivors. PCPs who received SCPs from oncologists were nine times more likely to report survivorship discussions with survivors.
Emphasizing that a minority of both PCPs and oncologists reported consistently discussing and providing SCPs to cancer survivors, the researchers suggest that training and knowledge specific to survivorship care and coordinated care between PCPs and oncologists were associated with increased survivorship discussions with survivors.
Lead study author Danielle Blanch Hartigan, Ph.D., MPH, of the National Cancer Institute (NCI) told Healthline, “Results from this nationally-representative survey of oncologists and PCPs suggest that discussion of survivorship care planning with cancer survivors does not always occur. Involving survivors in the survivorship care planning process may promote patient-centered follow-up care.”
Responding to a query from Healthline about the implications of the study for cancer survivors and providers, Hartigan went on to suggest that increased physician training about survivorship care and better care coordination between providers may increase discussions with survivors about follow-up care.
“Cancer survivors often have unique healthcare needs as a result of their cancer treatment. These needs include prevention or management of chronic and late physical and psychosocial effects of treatment and comorbid conditions. Written SCPs and the discussion about follow-up care seek to ensure survivors have the resources available to meet these needs,” said Hartigan.