scholarly journals Evidence Gaps in Cancer Survivorship Care: A Report from the 2019 National Cancer Institute Cancer Survivorship Workshop

2021 ◽  
Author(s):  
Lisa Gallicchio ◽  
Emily Tonorezos ◽  
Janet S de Moor ◽  
Joanne Elena ◽  
Margaret Farrell ◽  
...  
Keyword(s):  
Cancer Survivors ◽  
Cancer Survivorship ◽  
National Cancer Institute ◽  
Quality Care ◽  
Research Priorities ◽  
The United States ◽  
Institute Of Medicine ◽  
Survivorship Care ◽  
Psychosocial Effects

Abstract Today, there are more than 16.9 million cancer survivors in the United States; this number is projected to grow to 22.2 million by 2030. While much progress has been made in understanding cancer survivors needs and in improving survivorship care since the seminal 2006 Institute of Medicine report From Cancer Patient to Cancer Survivor: Lost in Transition, there is a need to identify evidence gaps and research priorities pertaining to cancer survivorship. Thus, in April 2019, the National Cancer Institute convened grant-funded extramural cancer survivorship researchers, representatives of professional organizations, cancer survivors, and advocates for a one-day in-person meeting. At this meeting, and in a subsequent webinar aimed at soliciting input from the wider survivorship community, evidence gaps and ideas for next steps in the following six areas, identified from the 2006 Institute of Medicine report, were discussed: surveillance for recurrence and new cancers, management of long-term and late physical effects, management of long-term and late psychosocial effects, health promotion, care coordination, and financial hardship. Identified evidence gaps and next steps across the areas included the need to understand and address disparities among cancer survivors, to conduct longitudinal studies as well as longer-term (>5 years post-diagnosis) follow-up studies, to leverage existing data, and to incorporate implementation science strategies to translate findings into practice. Designing studies to address these broad evidence gaps, as well as those identified in each area, will expand our understanding of cancer survivors’ diverse needs, ultimately leading to the development and delivery of more comprehensive evidence-based quality care.

scholarly journals Developing a Quality of Cancer Survivorship Care Framework: Implications for Clinical Care, Research, and Policy

2019 ◽  
Vol 111 (11) ◽  
pp. 1120-1130 ◽  
Author(s):  
Larissa Nekhlyudov ◽  
Michelle A Mollica ◽  
Paul B Jacobsen ◽  
Deborah K Mayer ◽  
Lawrence N Shulman ◽  
...  
Keyword(s):  
Cancer Survivors ◽  
Cancer Survivorship ◽  
Clinical Care ◽  
The United States ◽  
Care Quality ◽  
Clinical Settings ◽  
Institute Of Medicine ◽  
Survivorship Care ◽  
Quality Framework ◽  
Research And Policy

Abstract There are now close to 17 million cancer survivors in the United States, and this number is expected to continue to grow. One decade ago the Institute of Medicine report, From Cancer Patient to Cancer Survivor: Lost in Transition, outlined 10 recommendations aiming to provide coordinated, comprehensive care for cancer survivors. Although there has been noteworthy progress made since the release of the report, gaps remain in research, clinical practice, and policy. Specifically, the recommendation calling for the development of quality measures in cancer survivorship care has yet to be fulfilled. In this commentary, we describe the development of a comprehensive, evidence-based cancer survivorship care quality framework and propose the next steps to systematically apply it in clinical settings, research, and policy.

Models of Cancer Survivorship Health Care: Moving Forward

2014 ◽  
pp. 205-213 ◽  
Author(s):  
Kevin C. Oeffinger ◽  
Keith E. Argenbright ◽  
Gill A. Levitt ◽  
Mary S. McCabe ◽  
Paula R. Anderson ◽  
...  
Keyword(s):  
Health Care ◽  
Cancer Survivors ◽  
Cancer Survivorship ◽  
Quality Care ◽  
Community Setting ◽  
The United States ◽  
Health Conditions ◽  
Cancer Center ◽  
Survivorship Care ◽  
Indirect Consequence

The population of cancer survivors in the United States and worldwide is rapidly increasing. Many survivors will develop health conditions as a direct or indirect consequence of their cancer therapy. Thus, models to deliver high-quality care for cancer survivors are evolving. We provide examples of three different models of survivorship care from a cancer center, a community setting, and a country-wide health care system, followed by a description of the ASCO Cancer Survivorship Compendium, a tool to help providers understand the various models of survivorship care available and integrate survivorship care into their practices in a way that fits their unique needs.

Cancer survivorship care in the rural community: A mobile model.

2016 ◽  
Vol 34 (3_suppl) ◽  
pp. 38-38
Author(s):  
Keith Edward Argenbright ◽  
Emily Berry ◽  
Tracy Mazour ◽  
Stephanie L. Lawrence
Keyword(s):  
Cancer Survivors ◽  
Cancer Survivorship ◽  
Physician Assistant ◽  
Cost Of Care ◽  
Survivorship Care ◽  
Mobile Clinic ◽  
Psychosocial Effects ◽  
Care Plans ◽  
Screening And Surveillance

38 Background: As survival rates continue to improve, many forms of cancer are now regarded as chronic diseases requiring long-term follow-up. This survivorship phase of care represents a distinct opportunity to improve the health and quality of life for cancer survivors, addressing the lingering medical and psychosocial effects of illness, recurrent or new cancers, and promoting health behavior changes. Evidence-based cancer survivorship programs are typically limited in scope and only found in large cancer centers because they are costly and poorly reimbursed. As a result, UT Southwestern Moncrief Cancer Institute (UTSW-MCI) mobilized its clinic to provide essential survivorship services to the estimated 15,000 underserved cancer survivors in geographically remote areas of North Texas. Methods: UTSW-MCI provides survivorship care to Medicaid-enrolled and uninsured patients within a nine county service area using a custom-built mobile health unit. Staffed with an experienced team of nurses, social workers, dietitians, exercise specialists and physician assistant, services on the mobile clinic include: cancer screening and surveillance; medical management of long-term side effects of treatment; treatment summary and care plans; dietary evaluations and healthy lifestyle education; psychosocial evaluations, care coordination and navigation to financial assistance; and assessments for balance, immobility, range of motion, and safe physical activity. In-house providers with the ambulatory clinic are also able to see patients on the mobile unit using telemedicine. These services include genetic counseling, physician assistant evaluations, and psychological counseling. Results: After six months, mobile clinic enrollments represent more than 10% (N = 28) of the survivorship program patient population and nearly 15% (N = 130) of completed encounters, including 28 RN assessments, 26 Social Work evaluations, 21 Dietitian assessments, 53 Exercise sessions, and 3 PA consultations. Conclusions: This innovative survivorship care model addresses barriers that impede access to care to improve both the health of medically underserved cancer survivors and the experience of care while reducing the cost of care without compromising quality.

Cancer Survivorship Care in Colombia: Review and Implications for Health Policy

2021 ◽  
pp. 154041532110015
Author(s):  
Oscar Yesid Franco-Rocha ◽  
Gloria Mabel Carillo-Gonzalez ◽  
Alexandra Garcia ◽  
Ashley Henneghan
Keyword(s):  
Health Care ◽  
Health Policy ◽  
Cancer Survivors ◽  
Cancer Survivorship ◽  
Policy Development ◽  
Care Delivery ◽  
Developed Countries ◽  
The United States ◽  
Survivorship Care ◽  
Cancer Symptoms

Introduction: The number of cancer survivors is increasing in Colombia, and health policy changes are necessary to meet their unmet needs and improve their health outcomes. Similar trends have been identified in developed countries, and positive changes have been made. Methods: We conducted a narrative review to provide an overview of Colombia’s social structure, health care system, and health care delivery in relation to cancer, with recommendations for improving cancer survivorship in Colombia based on the model of survivorship care in the United States. Results: We proposed general recommendations for improving cancer survivors’ care including (1) recognizing cancer survivorship as a distinct phase of cancer, (2) strengthening methods and metrics for tracking cancer survivorship, (3) assessing and monitoring cancer symptoms and quality of life of cancer survivors, (4) publishing evidence-based guidelines considering the social, economic, and cultural characteristics of Colombian population and cancer survivors’ specific needs. Conclusion: These recommendations could be used to inform and prioritize health policy development in Colombia related to cancer survivorship outcomes.

scholarly journals Changes among US Cancer Survivors: Comparing Demographic, Diagnostic, and Health Care Findings from the 1992 and 2010 National Health Interview Surveys

ISRN Oncology ◽  
2013 ◽  
Vol 2013 ◽  
pp. 1-9 ◽  
Author(s):  
Natasha D. Buchanan ◽  
Jessica B. King ◽  
Juan L. Rodriguez ◽  
Arica White ◽  
Katrina F. Trivers ◽  
...  
Keyword(s):  
Cancer Survivors ◽  
Support Groups ◽  
National Health ◽  
Clinical Care ◽  
Quality Care ◽  
Insurance Coverage ◽  
Cancer Control ◽  
The United States ◽  
Institute Of Medicine ◽  
Health Interview

Background. Differences in healthcare and cancer treatment for cancer survivors in the United States (US) have not been routinely examined in nationally representative samples or studied before and after important Institute of Medicine (IOM) recommendations calling for higher quality care provision and attention to comprehensive cancer care for cancer survivors. Methods. To assess differences between survivor characteristics in 1992 and 2010, we conducted descriptive analyses of 1992 and 2010 National Health Interview Survey (NHIS) data. Our study sample consisted of 1018 self-reported cancer survivors from the 1992 NHIS and 1718 self-reported cancer survivors from the 2010 NHIS who completed the Cancer Control (CCS) and Cancer Epidemiology (CES) Supplements. Results. The prevalence of reported survivors increased from 1992 to 2010 (4.2% versus 6.3%). From 1992 to 2010, there was an increase in long-term cancer survivors and a drop in multiple malignancies, and surgery remained the most widely used treatment. Significantly fewer survivors (<10 years after diagnosis) were denied insurance coverage. Survivors continue to report low participation in counseling or support groups. Conclusions. As the prevalence of cancer survivors continues to grow, monitoring differences in survivor characteristics can be useful in evaluating the effects of policy recommendations and the quality of clinical care.

Growing a cancer survivorship care plan program.

2017 ◽  
Vol 35 (5_suppl) ◽  
pp. 58-58
Author(s):  
Claire Michelle Sutherby (Bennett)
Keyword(s):  
Cancer Survivors ◽  
Cancer Survivorship ◽  
The United States ◽  
Primary Treatment ◽  
Care Plan ◽  
Survivorship Care Plan ◽  
Close Monitoring ◽  
Survivorship Care ◽  
Oncology Nurse ◽  
Nurse Navigator

58 Background: More than 15.5 million cancer survivors live in the United States. This number is expected to be over 20 million by 2026. Cancer survivors have increased risk of morbidity; therefore, preventive and on-going medical treatment requires close monitoring and coordination. The Institute of Medicine’s (IOM) 2005 report, Cancer Patient to Cancer Survivor: Lost in Transition, recommended health providers raise awareness of cancer survivors’ needs and establish cancer survivorship as a distinct phase of care. The IOM also recommended patients who complete primary treatment are provided a comprehensive summary and plan that is effectively explained. A survivorship care plan maps out and improves care related to accessibility of past diagnosis and treatment history, surveillance guidelines, and potential long term side effects. In 2012, the Commission on Cancer (CoC) added Standard 3.3 Survivorship Care Planto the program standards. This met the IOM’s objective of addressing potential patients that get “lost” as they transition from care they received during treatment through phases of their life or disease. Methods: The Cancer Committee within a CoC certified organization developed multiple strategies to address the IOM and CoC standards. Strategies included a process to disseminate a comprehensive care summary for cancer patients who are completing primary treatment, adoption of the American Society of Clinical Oncology’s Treatment Summary and Survivorship Care Plan template, and adding a survivorship nurse navigator to the interprofessional treatment team. The survivorship nurse navigator monitors and reviews survivorship care plans with patients, advises when to seek treatment for symptoms, discusses surveillance guidelines, navigates patients through therapies, and educates on prevention and screening. Results: Evaluation for quality of life and compliance with individualized surveillance guidelines is ongoing. Conclusions: The oncology nurse navigator role is uniquely positioned to lead care coordination and improve outcomes through the continuum of care. Providing patients with a summary of their treatment and a plan moving forward may decrease stress related to the transition from active treatment to survivorship.

scholarly journals Current practice patterns and gaps in guideline-concordant breast cancer survivorship care

2021 ◽  
Author(s):  
Eden R. Brauer ◽  
Elisa F. Long ◽  
Laura Petersen ◽  
Patricia A. Ganz
Keyword(s):  
Breast Cancer ◽  
Cancer Survivors ◽  
Cancer Survivorship ◽  
Late Effects ◽  
Breast Cancer Survivors ◽  
Practice Patterns ◽  
Survivorship Care ◽  
Care Guidelines ◽  
Composite Scores

Abstract Purpose Breast cancer-specific survivorship care guidelines for the more than 3.8 million survivors in the U.S. are available, but implementation in clinical practice remains challenging. We examined current practice patterns and factors associated with guideline-concordant survivorship care among oncologists. Methods A national sample of medical oncologists, recruited using two databases, participated in a survey focused on practice patterns for breast cancer survivorship care. A “survivorship care composite score” was calculated for each respondent based on provision of services recommended in the survivorship guidelines. Descriptive statistics and multivariable linear regression analyses examined associations between physician and practice characteristics and composite scores. Results The survey was completed by 217 medical oncologists, with an overall response rate of 17.9% and eligibility rate of 56.9% for those who responded. Oncologists reported high engagement in evaluation of disease recurrence (78%). Performed less frequently were the provision of survivorship care plans (46%), assessment of psychosocial long-term and late effects (34%), and screening for subsequent cancers (34%). Lack of survivorship care training (p = 0.038) and not routinely informing patients about potential late effects (p = 0.003) were significantly associated with poorer survivorship care composite scores. Conclusions Despite the availability of disease-specific survivorship care guidelines, adherence to their recommendations in clinical practice is suboptimal. Survey results identified key gaps in survivorship care for breast cancer survivors, particularly related to subsequent primary cancers and psychosocial long-term and late effects. Implications for Cancer Survivors Improving the delivery of comprehensive survivorship care for the growing population of breast cancer survivors is a high priority. Disease-specific clinical guidelines for cancer survivorship provide valuable recommendations, but innovative strategies are needed to integrate them into the care of long-term breast cancer survivors.

Enhancing Research on Cancer Survivors

2006 ◽  
Vol 24 (32) ◽  
pp. 5149-5153 ◽  
Author(s):  
John Z. Ayanian ◽  
Paul B. Jacobsen
Keyword(s):  
Quality Of Life ◽  
Quality Of Care ◽  
Cancer Survivors ◽  
Cancer Registries ◽  
The United States ◽  
Institute Of Medicine ◽  
Survivorship Care ◽  
Care Plans ◽  
And Performance

The United States devotes substantial resources to understanding the etiologies of cancer and improving treatments, but much less research has focused on the needs of cancer survivors after they have completed active treatment. This article augments findings from the Institute of Medicine about cancer survivorship research and ways to enhance quality of life and quality of care. Studies of cancer survivors should focus on mechanisms and risk factors for impaired quality of life and evaluate interventions to improve this domain. Research to improve quality of care should concentrate on survivorship care plans, surveillance tests, respective roles of primary and specialty care, and performance measures related to survivorship care. Opportunities to expand research on cancer survivors include clinical trials, large cohort studies, cancer registries, and national surveys. Research to understand the needs of cancer survivors will provide a foundation for effective programs to meet these needs.

scholarly journals Disparities and Barriers to Pediatric Cancer Survivorship Care

2021 ◽  
Author(s):  
Erin M. Mobley ◽  
Diana J. Moke ◽  
Joel Milam ◽  
Carol Y. Ochoa ◽  
Julia Stal ◽  
...  
Keyword(s):  
Cancer Survivors ◽  
Childhood Cancer ◽  
Cancer Survivorship ◽  
Pediatric Cancer ◽  
Barriers To Care ◽  
Grey Literature ◽  
Childhood Cancer Survivors ◽  
The United States ◽  
Survivorship Care ◽  
Key Informants

Objectives. Survival rates for pediatric cancer have dramatically increased since the 1970s, and the population of childhood cancer survivors (CCS) exceeds 500,000 in the United States. Cancer during childhood and related treatments lead to long-term health problems, many of which are poorly understood. These problems can be amplified by suboptimal survivorship care. This report provides an overview of the existing evidence and forthcoming research relevant to disparities and barriers for pediatric cancer survivorship care, outlines pending questions, and offers guidance for future research. Data sources. This Technical Brief reviews published peer-reviewed literature, grey literature, and Key Informant interviews to answer five Guiding Questions regarding disparities in the care of pediatric survivors, barriers to cancer survivorship care, proposed strategies, evaluated interventions, and future directions. Review methods. We searched research databases, research registries, and published reviews for ongoing and published studies in CCS to October 2020. We used the authors’ definition of CCS; where not specified, CCS included those diagnosed with any cancer prior to age 21. The grey literature search included relevant professional and nonprofit organizational websites and guideline clearinghouses. Key Informants provided content expertise regarding published and ongoing research, and recommended approaches to fill identified gaps. Results. In total, 110 studies met inclusion criteria. We identified 26 studies that assessed disparities in survivorship care for CCS. Key Informants discussed subgroups of CCS by race or ethnicity, sex, socioeconomic status, and insurance coverage that may experience disparities in survivorship care, and these were supported in the published literature. Key Informants indicated that major barriers to care are providers (e.g., insufficient knowledge), the health system (e.g., availability of services), and payers (e.g., network adequacy); we identified 47 studies that assessed a large range of barriers to survivorship care. Sixteen organizations have outlined strategies to address pediatric survivorship care. Our searches identified only 27 published studies that evaluated interventions to alleviate disparities and reduce barriers to care. These predominantly assessed approaches that targeted patients. We found only eight ongoing studies that evaluated strategies to address disparities and barriers. Conclusions. While research has addressed disparities and barriers to survivorship care for childhood cancer survivors, evidence-based interventions to address these disparities and barriers to care are sparse. Additional research is also needed to examine less frequently studied disparities and barriers and to evaluate ameliorative strategies in order to improve the survivorship care for CCS.

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