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Tarver WL, Justice Z, Jonnalagadda P, Rahurkar S, Obeng-Gyasi S, Krok-Schoen JL, Petrecca A, Paskett ED. A scoping review of the evidence on survivorship care plans among minority, rural, and low-income populations. J Cancer Surviv 2024:10.1007/s11764-024-01609-z. [PMID: 38907799 DOI: 10.1007/s11764-024-01609-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2023] [Accepted: 04/19/2024] [Indexed: 06/24/2024]
Abstract
PURPOSE Despite recent advances in cancer control and the number of cancer survivors increasing substantially over the past years, some cancer survivors continue to experience disparities due to barriers to recommended survivorship care. The use of survivorship care plans (SCPs) may be a way to help care for these individuals and their respective issues after they complete their primary treatment. The purpose of this scoping review is to understand the evidence on SCPs among minority, rural, and low-income populations: groups that experience disproportionately poorer cancer health outcomes. METHODS Computer-based searches were conducted in four academic databases. We included peer-reviewed studies published in the English language and conducted in the USA. We systematically extracted information from each paper meeting our inclusion criteria. RESULTS Our search identified 45 articles. The 4 major themes identified were (1) disparities in the receipt of SCPs where populations experience unmet needs; (2) benefits of SCPs, including improved care coordination and self-management of cancer; (3) needs and preferences for survivorship care; and (4) barriers and facilitators to using SCPs. CONCLUSIONS Despite the potential benefits, underserved cancer survivors experience disparities in the receipt of SCPs and continue to have unmet needs in their survivorship care. Survivorship care may benefit from a risk-stratified approach where SCPs are prioritized to survivors belonging to high-risk groups. IMPLICATIONS FOR CANCER SURVIVORS SCPs are a tool to deliver quality care for cancer survivors. While evidence is mixed on SCPs' benefits among the general population, SCPs show promise for underserved populations when it comes to proximal outcomes that contribute to disparities.
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Affiliation(s)
- Willi L Tarver
- James Comprehensive Cancer Center, The Ohio State University, Columbus, OH, USA.
- Division of Cancer Prevention and Control, Department of Internal Medicine, College of Medicine, The Ohio State University, Columbus, OH, USA.
- The Center for the Advancement of Team Science, Analytics, and Systems Thinking in Health Services and Implementation Science Research (CATALYST), College of Medicine, The Ohio State University, Columbus, OH, USA.
| | | | - Pallavi Jonnalagadda
- The Center for the Advancement of Team Science, Analytics, and Systems Thinking in Health Services and Implementation Science Research (CATALYST), College of Medicine, The Ohio State University, Columbus, OH, USA
| | - Saurabh Rahurkar
- The Center for the Advancement of Team Science, Analytics, and Systems Thinking in Health Services and Implementation Science Research (CATALYST), College of Medicine, The Ohio State University, Columbus, OH, USA
- Department of Biomedical Informatics, College of Medicine, The Ohio State University, Columbus, OH, USA
| | - Samilia Obeng-Gyasi
- Division of Surgical Oncology, Department of Surgery, The Ohio State University, Columbus, OH, USA
| | - Jessica L Krok-Schoen
- Division of Health Sciences, School of Health and Rehabilitation Sciences, The Ohio State University, Columbus, OH, USA
| | - Abigail Petrecca
- The Center for the Advancement of Team Science, Analytics, and Systems Thinking in Health Services and Implementation Science Research (CATALYST), College of Medicine, The Ohio State University, Columbus, OH, USA
| | - Electra D Paskett
- James Comprehensive Cancer Center, The Ohio State University, Columbus, OH, USA
- Division of Cancer Prevention and Control, Department of Internal Medicine, College of Medicine, The Ohio State University, Columbus, OH, USA
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Schlairet MC, Heddon MA, Randolph J. Predicting Survivorship Appointment Nonattendance in a Community Cancer Center: A Machine-Learning Approach. West J Nurs Res 2023; 45:607-617. [PMID: 37085980 DOI: 10.1177/01939459231165749] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/23/2023]
Abstract
Understanding and predicting cancer survivors' health care utilization is critical to promote quality care. The consultative system of survivorship care uses a onetime consultative appointment to transition patients from active treatment into survivorship follow-up care. Knowledge of attributes associated with nonattendance at this essential appointment is needed. An ability to predict patients with a likelihood of nonattendance would be of value to practitioners. Unfortunately, traditional data modeling techniques may not be useful in working with large numbers of variables from electronic medical record platforms. A variety of machine-learning algorithms were used to develop a model for predicting 843 survivors' nonattendance at a comprehensive community cancer center in the southeastern United States. A parsimonious model resulted in a k-fold classification accuracy of 67.3% and included three variables. Practitioners may be able to increase utilization of follow-up care among survivors by knowing which patient groups are more likely to be survivorship appointment nonattenders.
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Affiliation(s)
- Maura C Schlairet
- Georgia Baptist College of Nursing, Mercer University, Atlanta, GA, USA
| | - Mary Ann Heddon
- Clinical Trials Program, Pearlman Cancer Center of South Georgia Medical Center, Valdosta, GA, USA
| | - Justus Randolph
- Georgia Baptist College of Nursing, Mercer University, Atlanta, GA, USA
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3
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Kamminga NCW, Wakkee M, De Bruin RJ, van der Veldt AAM, Joosse A, Reeder SWI, Plaisier PW, Nijsten T, Lugtenberg M. Oncological healthcare providers' perspectives on appropriate melanoma survivorship care: a qualitative focus group study. BMC Cancer 2023; 23:278. [PMID: 36973713 PMCID: PMC10042579 DOI: 10.1186/s12885-023-10759-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2022] [Accepted: 03/21/2023] [Indexed: 03/29/2023] Open
Abstract
BACKGROUND The increasing group of melanoma survivors reports multiple unmet needs regarding survivorship care (SSC). To optimise melanoma SSC, it is crucial to take into account the perspectives of oncological healthcare providers (HCPs) in addition to those of patients. The aim of this study is to gain an in-depth understanding of HCPs' perspectives on appropriate melanoma SSC. METHODS Four online focus groups were conducted with mixed samples of oncological HCPs (dermatologists, surgeons, oncologists, oncological nurse practitioners, support counsellors and general practitioners) (total n = 23). A topic guide was used to structure the discussions, focusing on perspectives on both SSC and survivorship care plans (SCPs). All focus groups were recorded, transcribed verbatim, and subjected to an elaborate thematic content analysis. RESULTS Regarding SSC, HCPs considered the current offer minimal and stressed the need for broader personalised SSC from diagnosis onwards. Although hardly anyone was familiar with SCPs, they perceived various potential benefits of SCPs, such as an increase in the patients' self-management and providing HCPs with an up-to-date overview of the patient's situation. Perceived preconditions for successful implementation included adequate personalisation, integration in the electronic health record and ensuring adequate funding to activate and provide timely updates. CONCLUSIONS According to HCPs there is considerable room for improvement in terms of melanoma SSC. SCPs can assist in offering personalised and broader i.e., including psychosocial SSC. Aside from personalisation, efforts should be focused on SCPs' integration in clinical practice, and their long-term maintenance.
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Affiliation(s)
- Nadia C W Kamminga
- Department of Dermatology, Erasmus MC Cancer Institute, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Marlies Wakkee
- Department of Dermatology, Erasmus MC Cancer Institute, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Rianne J De Bruin
- Department of Dermatology, Erasmus MC Cancer Institute, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Astrid A M van der Veldt
- Department of Medical Oncology, Erasmus MC Cancer Institute, University Medical Center Rotterdam, Rotterdam, The Netherlands
- Department of Radiology & Nuclear Medicine, Erasmus MC Cancer Institute, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Arjen Joosse
- Department of Medical Oncology, Erasmus MC Cancer Institute, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Suzan W I Reeder
- Department of Dermatology, Albert Schweitzer Hospital, Dordrecht, The Netherlands
| | - Peter W Plaisier
- Department of Surgical Oncology, Albert Schweitzer Hospital, Dordrecht, The Netherlands
| | - Tamar Nijsten
- Department of Dermatology, Erasmus MC Cancer Institute, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Marjolein Lugtenberg
- Department of Dermatology, Erasmus MC Cancer Institute, University Medical Center Rotterdam, Rotterdam, The Netherlands.
- Department Tranzo, Tilburg School of Social and Behavioral Sciences, Tilburg University, Tilburg, The Netherlands.
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4
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Shay LA, Schmidt S, Cornell SD, Parsons HM. "Making My Own Decisions Sometimes": A Pilot Study of Young Adult Cancer Survivors' Perspectives on Medical Decision-Making. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2018; 33:1341-1346. [PMID: 28752237 PMCID: PMC5787043 DOI: 10.1007/s13187-017-1256-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
This study aimed to provide a better understanding of the medical decision-making preferences and experiences of young adult survivors of pediatric, adolescent, and young adult cancers. We conducted key informant interviews and a cross-sectional mailed survey with young adult survivors (currently aged 18-39 years) of pediatric, adolescent, and young adult cancers in South Texas. Of the responding survivors, almost all wanted to be actively involved in medical decision-making, but preferences regarding family and doctor involvement varied. In open-ended responses, the most commonly reported concerns related to medical decision-making were feelings of uncertainty and fear of receiving bad news. Survivors reported that they desired more information in order to feel better about medical decision-making. Due to the variety of preferences regarding decision-making and who to include in the process, physicians should be prepared to ask and accommodate patients regarding their decision-making preferences.
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Affiliation(s)
- L Aubree Shay
- UTHealth School of Public Health in San Antonio, 7411 John Smith Dr., Suite 1100, San Antonio, TX, 78229, USA.
| | - Susanne Schmidt
- University of Texas Health Science Center San Antonio, San Antonio, TX, USA
| | - Stephanie D Cornell
- UTHealth School of Public Health in San Antonio, 7411 John Smith Dr., Suite 1100, San Antonio, TX, 78229, USA
- University of Texas Health Science Center San Antonio, San Antonio, TX, USA
| | - Helen M Parsons
- University of Minnesota School of Public Health, Minneapolis, MN, USA
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5
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Reed SC, Walker R, Ziebell R, Rabin B, Nutt S, Chubak J, Nekhlyudov L. Cancer Survivors' Reported Discussions with Health Care Providers About Follow-Up Care and Receipt of Written Care Plans. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2018; 33:1181-1188. [PMID: 28480500 DOI: 10.1007/s13187-017-1228-1] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Prior studies reveal gaps in cancer survivors' discussions with health care providers about follow-up care and receipt of care plans; however, whether survivorship care planning may vary by cancer type is not known. We surveyed 615 survivors of breast, colorectal, prostate, lung cancer, and melanoma enrolled in three health plans to examine cancer survivors' self-reported discussions of follow-up care, including the need for surveillance, late and long-term effects, emotional needs, and health behaviors. We assessed whether cancer survivors received a written treatment summary and post-treatment care instructions. Most (92%) survivors reported having a discussion about the need for surveillance; 75%, late and long-term effects; 69%, lifestyle and health behaviors; and 53%, emotional and social needs. Most (88%) reported receiving post-treatment care instructions and 47%, a treatment summary. While there was little difference among survivors' receipt of surveillance or health behavior recommendations by cancer type (p = 0.85 and p = 0.66, respectively), discussions of late and long-term effects occurred among 82% of prostate, 78% of breast, 73% of melanoma, 72% of colorectal, and 67% of lung survivors (p = 0.06). Approximately half of survivors reported discussions of emotional needs, with modest differences by cancer type (p = 0.08). Our findings indicate that most patient-provider discussions cover information on surveillance, with less emphasis on late and long-term effects, lifestyle and health behaviors, and substantially less focusing on emotional and social needs. No or modest differences in discussions occurred by cancer type. Whether tailoring information to individual cancer survivor needs is beneficial should be examined.
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Affiliation(s)
- Sarah C Reed
- Jane Addams College of Social Work, University of Illinois at Chicago, 1040 West Harrison Street, Chicago, IL, 60607-7134, USA.
| | - Rod Walker
- Kaiser Permanente Health Research Institute, Seattle, WA, USA
| | - Rebecca Ziebell
- Kaiser Permanente Health Research Institute, Seattle, WA, USA
| | - Borsika Rabin
- Department of Family Medicine and Public Health, University of California San Diego, La Jolla, CA, USA
| | - Stephanie Nutt
- Dell Medical School, University of Texas, Austin, TX, USA
| | - Jessica Chubak
- Kaiser Permanente Health Research Institute, Seattle, WA, USA
| | - Larissa Nekhlyudov
- Department of Population Medicine, Harvard Medical School and Department of Medicine, Brigham and Women's Hospital, Boston, MA, USA
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6
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Wu J, Blair J, Izevbigie OC, Wright NC, Arend RC. Disparities in receipt of follow-up care instructions among female adult cancer survivors: Results from a national survey. Gynecol Oncol 2018; 150:494-500. [DOI: 10.1016/j.ygyno.2018.06.024] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2018] [Revised: 06/21/2018] [Accepted: 06/23/2018] [Indexed: 01/11/2023]
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7
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Taylor K, Monterosso L, Bulsara C. Qualitative results from a phase II pilot randomised controlled trial of a lymphoma nurse-led model of survivorship care. Eur J Oncol Nurs 2018; 35:9-14. [DOI: 10.1016/j.ejon.2018.01.011] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2017] [Revised: 01/28/2018] [Accepted: 01/29/2018] [Indexed: 11/30/2022]
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8
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Fowler B, Ding Q, Pappas L, Wu YP, Linder L, Yancey J, Wright J, Clayton M, Kepka D, Kirchhoff AC. Utah Cancer Survivors: A Comprehensive Comparison of Health-Related Outcomes Between Survivors and Individuals Without a History of Cancer. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2018; 33:214-221. [PMID: 27592022 PMCID: PMC5532077 DOI: 10.1007/s13187-016-1098-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
Assessments of cancer survivors' health-related needs are often limited to national estimates. State-specific information is vital to inform state comprehensive cancer control efforts developed to support patients and providers. We investigated demographics, health status/quality of life, health behaviors, and health care characteristics of long-term Utah cancer survivors compared to Utahans without a history of cancer. Utah Behavioral Risk Factor Surveillance System (BRFSS) 2009 and 2010 data were used. Individuals diagnosed with cancer within the past 5 years were excluded. Multivariable survey weighted logistic regressions and computed predictive marginals were used to estimate age-adjusted percentages and 95 % confidence intervals (CI). A total of 11,320 eligible individuals (727 cancer survivors, 10,593 controls) were included. Respondents were primarily non-Hispanic White (95.3 % of survivors, 84.1 % of controls). Survivors were older (85 % of survivors ≥40 years of age vs. 47 % of controls). Survivors reported the majority of their cancer survivorship care was managed by primary care physicians or non-cancer specialists (93.5 %, 95 % CI = 87.9-99.1). Furthermore, 71.1 % (95 % CI = 59.2-82.9) of survivors reported that they did not receive a cancer treatment summary. In multivariable estimates, fair/poor general health was more common among survivors compared to controls (17.8 %, 95 % CI = 12.5-23.1 vs. 14.2 %, 95 % CI = 12.4-16.0). Few survivors in Utah receive follow-up care from a cancer specialist. Provider educational efforts are needed to promote knowledge of cancer survivor issues. Efforts should be made to improve continuity in follow-up care that addresses the known issues of long-term survivors that preclude optimal quality of life, resulting in a patient-centered approach to survivorship.
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Affiliation(s)
- Brynn Fowler
- Huntsman Cancer Institute, 2000 Circle of Hope Drive, Salt Lake City, UT, 84112, USA.
| | - Qian Ding
- Study Design and Biostatistics Center, University of Utah, 295 Chipeta Way, Salt Lake City, UT, 84112, USA
| | - Lisa Pappas
- Huntsman Cancer Institute, 2000 Circle of Hope Drive, Salt Lake City, UT, 84112, USA
- Study Design and Biostatistics Center, University of Utah, 295 Chipeta Way, Salt Lake City, UT, 84112, USA
| | - Yelena P Wu
- Huntsman Cancer Institute, 2000 Circle of Hope Drive, Salt Lake City, UT, 84112, USA
- Department of Family and Preventive Medicine, University of Utah, 375 Chipeta Way, Salt Lake City, UT, 84112, USA
| | - Lauri Linder
- College of Nursing, University of Utah, 10 South 2000 East, Salt Lake City, UT, 84112, USA
- Primary Children's Hospital, 100 Mario Capecchi Dr, Salt Lake City, UT, 84132, USA
| | - Jeff Yancey
- Huntsman Cancer Institute, 2000 Circle of Hope Drive, Salt Lake City, UT, 84112, USA
| | - Jennifer Wright
- Huntsman Cancer Institute, 2000 Circle of Hope Drive, Salt Lake City, UT, 84112, USA
- Primary Children's Hospital, 100 Mario Capecchi Dr, Salt Lake City, UT, 84132, USA
| | - Margaret Clayton
- College of Nursing, University of Utah, 10 South 2000 East, Salt Lake City, UT, 84112, USA
| | - Deanna Kepka
- Huntsman Cancer Institute, 2000 Circle of Hope Drive, Salt Lake City, UT, 84112, USA
- College of Nursing, University of Utah, 10 South 2000 East, Salt Lake City, UT, 84112, USA
| | - Anne C Kirchhoff
- Huntsman Cancer Institute, 2000 Circle of Hope Drive, Salt Lake City, UT, 84112, USA
- Department of Pediatrics, University of Utah, 295 Chipeta Way, Salt Lake City, UT, 84112, USA
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9
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Baseman J, Revere D, Baldwin LM. A Mobile Breast Cancer Survivorship Care App: Pilot Study. JMIR Cancer 2017; 3:e14. [PMID: 28951383 PMCID: PMC5635232 DOI: 10.2196/cancer.8192] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2017] [Revised: 08/21/2017] [Accepted: 08/29/2017] [Indexed: 12/27/2022] Open
Abstract
Background Cancer survivors living in rural areas experience unique challenges due to additional burdens, such as travel and limited access to specialists. Rural survivors of breast cancer have reported poorer outcomes, poorer mental health and physical functioning, and lower-than-average quality of life compared to urban survivors. Objective To explore the feasibility and acceptability of developing a mobile health survivorship care app to facilitate care coordination; support medical, psychosocial, and practical needs; and improve survivors' long-term health outcomes. Methods An interactive prototype app, SmartSurvivor, was developed that included recommended survivorship care plan components. The prototype's feasibility and acceptability were tested by a sample of breast cancer survivors (n=6), primary care providers (n=4), and an oncologist (n=1). Results Overall, both survivors and providers felt that SmartSurvivor was a potentially valuable tool to support long-term survivorship care plan objectives. Portability, accessibility, and having one place for all contact, treatment, symptom tracking, and medication summaries was highly valued. Conclusions Our pilot study indicates that SmartSurvivor is a feasible and acceptable approach to meeting survivorship care objectives and the needs of both breast cancer survivors and their health care providers. Exploration of mobile health options for supporting survivorship care plan needs is a promising area of research.
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Affiliation(s)
- Janet Baseman
- Department of Epidemiology, University of Washington, Seattle, WA, United States
| | - Debra Revere
- Department of Health Services, University of Washington, Seattle, WA, United States
| | - Laura-Mae Baldwin
- Department of Family Medicine, University of Washington, Seattle, WA, United States
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10
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Hinyard L, Wirth LS. Race is a Strong Predictor of Receipt of a Written Survivorship Care Plan: Results from the National Health Interview Survey. J Community Health 2017; 42:1156-1162. [PMID: 28455672 DOI: 10.1007/s10900-017-0365-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
The purpose of this study is to investigate the prevalence of receipt of written documentation of follow up care and of cancer treatments and to examine the predictors of receipt of such written documentation. Data from the 2010 National Health Interview Survey was used to identify individuals 18 years or older with a history of cancer. Binary and multinomial logistic regression were used to investigate patient-level variables associated with receipt of written documentation of cancer treatment, written advice about follow-up care, or both written documents. Patient-level variables included in the analysis were age, gender, region of residence, race/ethnicity, marital status, education level, insurance coverage, cancer type, employment status, and psychosocial support. Of the 1185 responses to the questions used to access receipt of a SCP, the prevalence of any receipt of a written documentation was 68%, where 30% obtained written advice only and 8% were provided a written treatment summary only; only 31% received both. Non-white race, cancer type, and psychosocial services were associated with increased odds of receiving written documentation. Patient-level characteristics are associated with receipt of care plan documentation. Further work needs to investigate the interaction of provider and patient-level characteristics. Understanding patient-level characteristics associated with receipt of written documentation may help uncover strategies for improved survivorship care plan implementation.
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Affiliation(s)
- Leslie Hinyard
- Saint Louis University Center for Health Outcomes Research, Saint Louis University Center for Interprofessional Education and Research, 3545 Lafayette Ave., Salus Center, Room 409, St. Louis, MO, 63104, USA. .,Saint Louis University Center for Health Outcomes Research, 3545 Lafayette Ave., Salus Center, 4th Floor, St. Louis, MO, 63104, USA.
| | - Lorinette S Wirth
- Saint Louis University Center for Health Outcomes Research, Saint Louis University Center for Interprofessional Education and Research, 3545 Lafayette Ave., Salus Center, Room 409, St. Louis, MO, 63104, USA
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11
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Selove R, Foster M, Wujcik D, Sanderson M, Hull PC, Shen-Miller D, Wolff S, Friedman D. Psychosocial concerns and needs of cancer survivors treated at a comprehensive cancer center and a community safety net hospital. Support Care Cancer 2016; 25:895-904. [PMID: 27822710 DOI: 10.1007/s00520-016-3479-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2016] [Accepted: 11/01/2016] [Indexed: 10/20/2022]
Affiliation(s)
- Rebecca Selove
- Tennessee State University, 3500 John A. Merritt Boulevard, Nashville, TN, 37209, USA.
| | - Maya Foster
- Tennessee State University, 3500 John A. Merritt Boulevard, Nashville, TN, 37209, USA
| | - Debra Wujcik
- Vanderbilt University, 2141 Blakemore Avenue, Nashville, TN, 37208, USA
| | - Maureen Sanderson
- Meharry Medical College, 1005 Dr. D.B. Todd Junior Boulevard, Nashville, TN, 37208, USA
| | - Pamela C Hull
- Vanderbilt University, 2525 West End Avenue, Suite 800, Nashville, TN, 37203, USA
| | - David Shen-Miller
- Tennessee State University, 3500 John A. Merritt Boulevard, Nashville, TN, 37209, USA
| | - Steven Wolff
- Meharry Medical College, 1005 Dr. D.B. Todd Junior Boulevard, Nashville, TN, 37208, USA
| | - Debra Friedman
- Vanderbilt University, 2220 Pierce Avenue, Nashville, TN, 37232, USA
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12
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de Rooij BH, Ezendam NPM, Nicolaije KAH, Vos MC, Pijnenborg JMA, Boll D, Kruitwagen RFPM, van de Poll-Franse LV. Factors influencing implementation of a survivorship care plan-a quantitative process evaluation of the ROGY Care trial. J Cancer Surviv 2016; 11:64-73. [PMID: 27480883 PMCID: PMC5266782 DOI: 10.1007/s11764-016-0562-3] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2016] [Accepted: 07/09/2016] [Indexed: 11/24/2022]
Abstract
Purpose The aim of this study is to investigate the factors that influence implementation of Survivorship Care Plans (SCPs) in the intervention arm of the ROGY Care trial by (1) assessing the level of SCP receipt in the ROGY Care trial and (2) identifying patient- and provider-level factors that influence SCP receipt. Methods Between 2011 and 2015, a pragmatic cluster randomized-controlled-trial was conducted on the effects of automatically generated SCPs. Endometrial (N = 117) and ovarian (N = 61) cancer patients were allocated to ‘SCP care’, as provided by their SCP care providers (N = 10). Associations between SCP receipt (self-reported SCP receipt and actually generated SCPs), patient-factors (socio-demographic-, clinical-, and personality factors), and care provider factors (profession and a-priori motivation regarding SCP provision) were tested in univariate analysis. The odds ratios of factors influencing self-reported SCP receipt were estimated with a multivariate regression model. Results Of all patients in the SCP care arm (N = 178), SCPs were generated by the care provider for 90 % of the patients and 70 % of the patients reported that they had received an SCP. Patients with older age, ovarian cancer, type D (distressed) personality, and patients that completed the questionnaire a longer period of time after the SCP consult were more likely to report no SCP receipt. Conclusions SCP receipt was influenced by patient- but not care-provider factors. Implications for cancer survivors Certain patient groups were less likely to report SCP receipt. Whether all patients are in need of an SCP, requires further investigation. If they do, more efforts need to be made towards the implementation of SCPs.
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Affiliation(s)
- Belle H de Rooij
- CoRPS-Center of Research on Psychology in Somatic diseases, Department of Medical and Clinical Psychology, Tilburg University, Tilburg, The Netherlands. .,The Netherlands Comprehensive Cancer Organisation, Utrecht, The Netherlands.
| | - Nicole P M Ezendam
- CoRPS-Center of Research on Psychology in Somatic diseases, Department of Medical and Clinical Psychology, Tilburg University, Tilburg, The Netherlands.,The Netherlands Comprehensive Cancer Organisation, Utrecht, The Netherlands
| | - Kim A H Nicolaije
- CoRPS-Center of Research on Psychology in Somatic diseases, Department of Medical and Clinical Psychology, Tilburg University, Tilburg, The Netherlands.,The Netherlands Comprehensive Cancer Organisation, Utrecht, The Netherlands
| | - M Caroline Vos
- Department of Obstetrics and Gynecology, Gynecologic Cancer Center South, Elisabeth-TweeSteden Hospital, Tilburg and Waalwijk, The Netherlands
| | - Johanna M A Pijnenborg
- Department of Obstetrics and Gynecology, Gynecologic Cancer Center South, Elisabeth-TweeSteden Hospital, Tilburg and Waalwijk, The Netherlands
| | - Dorry Boll
- Department of Obstetrics and Gynecology, Catharina Hospital, Eindhoven, The Netherlands
| | - Roy F P M Kruitwagen
- Department of Gynecology and GROW - School for Oncology and Developmental Biology, Maastricht University Medical Center, Maastricht, The Netherlands
| | - Lonneke V van de Poll-Franse
- CoRPS-Center of Research on Psychology in Somatic diseases, Department of Medical and Clinical Psychology, Tilburg University, Tilburg, The Netherlands.,The Netherlands Comprehensive Cancer Organisation, Utrecht, The Netherlands.,Division of Psychosocial Research and Epidemiology, The Netherlands Cancer Institute, Amsterdam, The Netherlands
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13
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Taylor K, Joske D, Bulsara M, Bulsara C, Monterosso L. Protocol for Care After Lymphoma (CALy) trial: a phase II pilot randomised controlled trial of a lymphoma nurse-led model of survivorship care. BMJ Open 2016; 6:e010817. [PMID: 27194317 PMCID: PMC4874152 DOI: 10.1136/bmjopen-2015-010817] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/05/2022] Open
Abstract
INTRODUCTION Lymphoma is the sixth most common cancer diagnosed in Australia and internationally. Owing to the aggressive nature of the disease and intensity of treatment, survivors face long-term effects that impact on quality of life. Current models of follow-up post-treatment fail to address these complex issues. Given that 74% of patients with lymphoma cancer now survive 5 years beyond diagnosis and treatment, it is important to address this gap in care. AIM To determine self-reported informational and practical needs, anxiety, depression, stress, coping and empowerment at baseline, 3 and 6 months. METHODS AND ANALYSIS A pilot randomised controlled trial will test the effect of a nurse-led lymphoma survivorship clinic compared with usual post-treatment care at a large tertiary cancer centre in Western Australia. The intervention will comprise three face-to-face appointments with delivery of tailored resources, a survivorship care plan and treatment summary (SCP TS). The SCP TS will be given to the participant and general practitioner (GP). Intervention participants will be interviewed at completion to explore the perceived value of the intervention components and preferred dose. An evaluation developed for GPs will assess receipt and use of SCP TS. The primary intent of analysis will be to address the feasibility of a larger trial and requisite effect and sample size. ETHICS AND DISSEMINATION Ethics approval has been granted by the University of Notre Dame Australia and Sir Charles Gairdner Hospital in Western Australia. Peer-reviewed publications and conference presentations will report the results of this phase II trial. TRIAL REGISTRATION NUMBER ANZCTRN12615000530527; Pre-results.
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Affiliation(s)
- Karen Taylor
- Western Australia Cancer and Palliative Care Network, Perth, Western Australia, Australia
- School of Nursing and Midwifery and Centre for Nursing and Midwifery Research, University of Notre Dame Australia, Fremantle, Western Australia, Australia
| | - David Joske
- Sir Charles Gairdner Hospital, Nedlands, Western Australia, Australia
- School of Medicine, University of Western Australia, Crawley, Western Australia, Australia
| | - Max Bulsara
- Institute for Health Research, University of Notre Dame Australia, Fremantle, Western Australia, Australia
| | - Caroline Bulsara
- School of Nursing and Midwifery and Centre for Nursing and Midwifery Research, University of Notre Dame Australia, Fremantle, Western Australia, Australia
| | - Leanne Monterosso
- School of Nursing and Midwifery and Centre for Nursing and Midwifery Research, University of Notre Dame Australia, Fremantle, Western Australia, Australia
- St John of God Hospital, Murdoch, Western Australia, Australia
- School of Nursing, Edith Cowan University, Joondalup, Western Australia, Australia
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Ryerson AB, Eheman C, Styles T, Rycroft R, Snyder C. Connecting the Dots: Linking the National Program of Cancer Registries and the Needs of Survivors and Clinicians. Am J Prev Med 2015; 49:S528-35. [PMID: 26590648 PMCID: PMC4656128 DOI: 10.1016/j.amepre.2015.08.026] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2015] [Revised: 08/24/2015] [Accepted: 08/31/2015] [Indexed: 12/14/2022]
Abstract
Cancer survivors, the medical community, public health professionals, researchers, and policymakers all need information about newly diagnosed cancer cases and deaths to better understand and address the disease burden. CDC collects cancer data on 96% of the U.S. population through the National Program of Cancer Registries. The National Program of Cancer Registries routinely collects data on all cancer occurrences, deaths, and the types of initial treatment received by the patients, and recently CDC has made advances in its cancer surveillance activities that have direct applicability to cancer survivorship research and care. This article examines CDC's innovative uses of the National Program of Cancer Registries infrastructure and data as a recruitment source for survivorship research studies and behavioral interventions; comparative effectiveness and patient-centered outcomes research; and the collection, consolidation, and dissemination of treatment summaries for cancer survivors and their providers. This paper also discusses long-term, idealistic plans for additional data linkages and sharing among public health, providers, and the cancer survivor through innovative concepts such as patient portals and rapid-learning health care.
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Affiliation(s)
- A Blythe Ryerson
- Division of Cancer Prevention and Control, CDC, Atlanta, Georgia.
| | - Christie Eheman
- Division of Cancer Prevention and Control, CDC, Atlanta, Georgia
| | - Timothy Styles
- Division of Cancer Prevention and Control, CDC, Atlanta, Georgia
| | - Randi Rycroft
- Colorado Central Cancer Registry, Colorado Department of Public Health and Environment, Denver, Colorado
| | - Claire Snyder
- Division of General Internal Medicine, Johns Hopkins School of Medicine; Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland; Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Baltimore, Maryland
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Hawkins NA, Berkowitz Z, Rodriguez J, Miller JW, Sabatino SA, Pollack LA. Examining Adherence With Recommendations for Follow-Up in the Prevention Among Colorectal Cancer Survivors Study. Oncol Nurs Forum 2015; 42:233-40. [PMID: 25901375 PMCID: PMC4501017 DOI: 10.1188/15.onf.233-240] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PURPOSE/OBJECTIVES To explore the impact of health professionals' recommendations for medical follow-up among colorectal cancer (CRC) survivors. DESIGN Cross-sectional survey. SETTING Mailed surveys and telephone interviews with CRC survivors in California. SAMPLE 593 adults diagnosed with a primary CRC six to seven years before the time of the study. METHODS Participants were identified through California Cancer Registry records and invited to take part in a survey delivered via mail or through telephone interview. MAIN RESEARCH VARIABLES The survey assessed cancer history, current preventive health practices, health status, demographics, and other cancer-related experiences. FINDINGS More than 70% of CRC survivors received recommendations for routine checkups, surveillance colonoscopy, or other cancer screenings after completing CRC treatment, and 18%-22% received no such recommendations. Recommendations were sometimes given in writing. Receiving a recommendation for a specific type of follow-up was associated with greater adherence to corresponding guidelines for routine checkups, colonoscopy, mammography, and Papanicolaou testing. Receiving written (versus unwritten) recommendations led to greater adherence only for colonoscopy. CONCLUSIONS Most CRC survivors reported receiving recommendations for long-term medical follow-up and largely adhered to guidelines for follow-up. Receiving a health professional's recommendation for follow-up was consistently associated with patient adherence, and limited evidence showed that recommendations in written form led to greater adherence than unwritten recommendations. IMPLICATIONS FOR NURSING Given the increasingly important role of the oncology nurse in survivorship care, nurses can be instrumental in ensuring appropriate surveillance and follow-up care among CRC survivors. Conveying recommendations in written form, as is done in survivorship care plans, may be particularly effective.
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Affiliation(s)
| | | | | | | | | | - Lori A Pollack
- Centers for Disease Control and Prevention in Atlanta, GA
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16
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Survivorship care plans and time since diagnosis: factors that contribute to who breast cancer survivors see for the majority of their care. Support Care Cancer 2015; 23:2669-76. [DOI: 10.1007/s00520-015-2629-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2014] [Accepted: 01/22/2015] [Indexed: 10/24/2022]
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Jabson JM. Follow-up care instructions, treatment summaries, and cancer survivors’ receipt of follow-up health care and late/long term effects. Support Care Cancer 2014; 23:1851-6. [DOI: 10.1007/s00520-014-2532-5] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2014] [Accepted: 11/17/2014] [Indexed: 11/29/2022]
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Birken SA, Deal AM, Mayer DK, Weiner BJ. Determinants of survivorship care plan use in US cancer programs. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2014; 29:720-7. [PMID: 24706174 PMCID: PMC4186915 DOI: 10.1007/s13187-014-0645-7] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Abstract
Cancer programs are increasingly required to use survivorship care plans (SCPs). Compliance with SCP use requirements will be evaluated at the cancer program level. Cancer program-level determinants of SCP use may suggest strategies for compliance. The objective of this study was to describe SCP use and identify its cancer program-level determinants. We surveyed employees knowledgeable about survivorship practices in cancer programs throughout the USA with a wide range of annual incident cancers, program types, and cancer care quality improvement organization memberships (81/100 response rate). We used descriptive statistics to describe SCP use and bivariate statistics to identify its cancer program-level determinants. Most respondents (56 %) reported that SCPs were not used. In programs reporting use, SCP use is restricted primarily to breast (82 %) and colorectal (55 %) cancer survivors, and few providers use SCPs. When developed, SCPs seldom reach survivors and their primary care providers. Most respondents (78 %) reported beginning to use SCPs because of requirements. Frequently cited barriers included insufficient resources (76 %), perceived difficulty using SCPs (29 %), and lack of advocacy for SCP use from influential people (24 %). SCP use was positively associated with academic program type (p = .009) and membership in the National Cancer Institute's Community Cancer Centers Program (p = .009) and negatively associated with freestanding program type (p = .02). SCP use in the US cancer programs is highly inconsistent. Many cancer programs plan to implement SCPs to comply with SCP use requirements. Support specifically intended to facilitate SCP use may be more effective than non-specific resources.
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Affiliation(s)
- Sarah A Birken
- Lineberger Comprehensive Cancer Center, The University of North Carolina at Chapel Hill, Chapel Hill, NC, 27599-7411, USA,
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Birken SA, Deal AM, Mayer DK, Weiner BJ. Following through: the consistency of survivorship care plan use in United States cancer programs. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2014; 29:689-97. [PMID: 24577781 PMCID: PMC4148470 DOI: 10.1007/s13187-014-0628-8] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/13/2023]
Abstract
The Institute of Medicine suggests that consistent survivorship care plan (SCP) use involves developing and delivering SCPs to all cancer survivors and their primary care providers (PCPs). We describe the consistency of SCP use in US cancer programs and assess its relationship with cancer-program-level determinants. We surveyed employees knowledgeable about survivorship practices in cancer programs reporting current SCP use (n = 36, 81 % response rate). We operationalized consistent SCP use as whether SCPs were (1) developed for ≥75 % survivors, (2) delivered to ≥75 % survivors, (3) delivered to ≥75 % PCPs, and (4) all of the above. We use descriptive statistics to report SCP use consistency and evaluate associations using Fisher's exact and Wilcoxon rank sum tests. SCPs were developed for ≥75 % survivors in five programs (15 %), eight (25 %) delivered ≥75 % SCPs to survivors, seven (23 %) delivered ≥75 % SCPs to PCPs, and only one program (4 %) met all three criteria. We found relationships between SCP use consistency and geographic region (p = .05), initiating SCP use in response to survivors' requests (p = .03), and membership in the National Cancer Institute's National Community Cancer Centers Program (p = .01). SCP use is highly inconsistent. Survivors and cancer care quality improvement organizations may play a key role in improving the consistency of SCP use in US cancer programs. Survivors can initiate SCP use. Cancer care quality improvement organizations can specify how cancer programs' compliance with SCP guidelines will be assessed. Future research should identify mechanisms underlying the relationships that we found.
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Affiliation(s)
- Sarah A Birken
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, 1107A McGavran-Greenberg Hall, Chapel Hill, NC, 27599, USA,
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Jabson JM, Bowen DJ. How do follow-up care instructions and treatment summaries relate to cancer survivors' cancer-related pain? J Pain Symptom Manage 2014; 48:1247-53. [PMID: 24780182 DOI: 10.1016/j.jpainsymman.2014.03.004] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/14/2013] [Revised: 02/25/2014] [Accepted: 04/02/2014] [Indexed: 10/25/2022]
Abstract
CONTEXT Cancer-related pain is a problem for many cancer survivors. Treatment summaries (TS) and follow-up care instructions (FCI) provided after cancer treatment could reduce pain for cancer survivors. OBJECTIVES This study sought to determine how TS and FCI received by cancer survivors relate to cancer survivors' cancer-related pain after treatment completion. METHODS Data were from 2010, Behavioral Risk Factor Surveillance System, Cancer Survivorship module, completed by 10 U.S. states and entities. RESULTS Pain was reported by 9% of survivors. TS (P = 0.02) and FCI (P < 0.001) were associated with pain. Compared with cancer survivors who had not received TS or FCI, those who received TS had greater odds of pain (odds ratio, 1.57; 95% confidence interval, 1.08-2.28) and those who received FCI had more than twice the odds of pain (odds ratio, 2.36; 95% confidence interval, 1.52-3.67). CONCLUSION FCI and TS were related to pain but in the opposite direction than predicted. Those who received TS and FCI were more likely to report pain than those who did not receive FCI and TS. This may be explained by the severity of cancer treatment. It is possible that those who undergo more severe cancer treatments are more likely to receive FCI and TS. Testing this relationship is a logical next step.
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Affiliation(s)
- Jennifer M Jabson
- Department of Public Health, University of Tennessee, Knoxville, Tennessee, USA.
| | - Deborah J Bowen
- University of Washington School of Medicine, Seattle, Washington, USA
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