Cancer as a Chronic Illness in Colombia: A Normative Consensus Approach to Improving Healthcare Services for those Living with and beyond Cancer and Its Treatment

Abstract

Cancer survivorship care in Colombia is of increasing importance. International survivorship initiatives and studies show that continuing symptoms, psychological distress, and late effects impact the quality of life for survivors. Priorities for quality survivorship according to Colombian patients and clinicians are unknown. We undertook a nominal consensus approach with 24 participants using virtual meeting technology to identify the priorities for cancer survivorship. We applied an iterative approach conducted over eight weeks with five workshops and one patient focus group followed by a priority setting survey. The consensus group established six main themes, which were subsequently evaluated by experts: (i) symptoms and secondary effects of cancer; (ii) care coordination to increase patient access and integration of cancer care; (iii) psychosocial support after cancer treatment; (iv) mapping information resources and available support services for long-term cancer care; (v) identifying socioeconomic and regional inequalities in cancer survival to improve care and outcomes; and (vi) health promotion and encouraging lifestyle change. The order of priorities differed between clinicians and patients: patients mentioned psychosocial support as the number one priority, and clinicians prioritized symptoms and surveillance for cancer recurrence. Developing survivorship care needs consideration of both views, including barriers such as access to services and socioeconomic disparities.

Cancer survivor late-effects, chronic health problems after cancer treatment: what’s the evidence from population and registry data and where are the gaps?

“…Consensus and policy groups have recognised evidence and service gaps in survivorship care and late effects management, across many countries and have called for better strategies and further research to improve the health of cancer survivors [46][47][48][49]. There have been calls for cancer care providers to adapt to changing cancer survivor demographics within older cancer populations but clearly, as seen in this review, late effects occur in those who are also younger with excess morbidity prevalent in all age groups compared with age-matched noncancer populations.…”

Self-Reported Health Problems and Quality of Life in a Sample of Colombian Childhood Cancer Survivors: A Descriptive Cross-Sectional Study

“…Currently, most high-income countries have guidelines for childhood cancer survivorship care [ 27 , 61 , 62 , 63 , 64 ]. In Colombia, follow-up care for cancer survivors is starting to be implemented among adult cancer survivors, but there is still a long way to go for implementing these strategies among CCS [ 65 ]. For the survivors of childhood cancer of this study, life after cancer also brings its challenges and concerns, such as the perceived risk of developing an adverse event after treatment, having a relapse, and concerns related to fertility.…”

Mitigating late effects in cancer survivors: harnessing personalised medicine and new models of care

“…Priority setting exercised in Columbia around survivorship [10] and in the UK around research priorities related to living with and beyond cancer [11] identified similar concerns including the identification of risk factors, ways to prevent and treat the side effects of cancer treatment and how to identify the best models of care for people experiencing the late effects of cancer treatment. In Columbia, there was more emphasis on information sharing between agencies for the benefit of patients, although this applies to the UK as well.…”