Disparities in receipt of follow-up care instructions among female adult cancer survivors: Results from a national survey

Wu, Jessica; Blair, Jessica; Izevbigie, O.; Wright, Nicole C.; Arend, Rebecca C.

doi:10.1016/j.ygyno.2018.06.024

Cited by 6 publications

(4 citation statements)

References 27 publications

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“…19,20 A more wellinformed patient is likely to seek care and focus on their well-being. 21 Using these data, we also examined the patient's recall of written information that they received about their treatment and follow-up instructions before seeing their physician for continuity of care.…”

Section: Introductionmentioning

confidence: 99%

Growing Need for Primary Care Physicians Caring for Cancer Survivors

Xierali

Rayburn

2022

J Am Board Fam Med

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Background: A rising population of cancer survivors is accompanied by a shortage of oncologists for continuity of care. This study examined the physicians who provided most of the care for cancer survivors, along with written information provided to the survivors before transfer of care.Methods: Data were collected through the CDC-sponsored Behavioral Risk Factor Surveillance System. Our analysis involved states whose respondents completed a cancer survivorship module from 2016 to 2020. Primary measures were the proportions of physician specialists who provided most of their subsequent health care and the proportions of survivors who received written summaries of their care and instructions.Results: The 36,737 cancer survivor respondents came from 33 states. Most of their health care came from primary care physicians [family physicians (42.3%, 95% CI: 41.3-43.2%) and general internists (26.0%, 95% CI: 25.2-26.9%)]. When seen by primary care physicians rather than subspecialists, a lower proportion of patients recalled receiving summaries of either their cancer treatments (44.3%, 95% CI: 42.5 to 46.2 vs 50.5%, 95% CI: 49.4 to 51.7%) or follow-up instructions (69.9%, 95% CI: 68.8 to 71.0% vs 78.7%, 95%CI 77.1 to 80.2%), regardless of their cancer type.Conclusions: Regardless of their cancer type, two-thirds of survivors received most of their health care from primary care physicians. Collaborative community-based care within a shared decision-making framework is essential to prioritize and individualize patients' understandings and needs in this growing population.

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Section: Introductionmentioning

confidence: 99%

Growing Need for Primary Care Physicians Caring for Cancer Survivors

Xierali

Rayburn

2022

J Am Board Fam Med

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“…Incidentally, this study also found that Hispanic cancer survivors were more likely to receive treatment summaries [37]. Wu and colleagues used BRFSS data and found that low-income breast cancer patients had lower odds of receiving follow-up care instructions from their providers [40].…”

Section: Theme 2: Receipt Of Survivorship Care Plansmentioning

confidence: 64%

A scoping review of the evidence on survivorship care plans among minority, rural, and low-income populations

Tarver,

Justice,

Jonnalagadda

et al. 2024

J Cancer Surviv

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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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“…While studies have been conducted to understand disparities in the use and impact of SCPs (12-14), there remains a knowledge gap in assessing racial/ethnic disparities in SCP receipt and utilization. Studies have examined disparities in SCP receipt among female cancer survivors using US BRFSS data (15)(16)(17). One study focusing on Alabama, Georgia, and Mississippi found that the likelihood of receiving follow-up instructions for survivors who were younger, with higher education and income levels was significantly higher compared to survivors who were older, with lower education and income levels (15).…”

Section: Introductionmentioning

confidence: 99%

“…Furthermore, Timsina et al ( 16) found that 7,061 cancer survivors who responded to 2016 BRFSS survey with lower educational levels, widowed/divorced/separated marital status, and without insurance were less likely to receive SCPs from their healthcare providers. Wu et al (17) evaluated predictors associated with receiving follow-up instructions among 954 women with breast cancer and 492 women with gynecologic cancers, and the researchers found that breast cancer patients with lower income levels were less likely to receive follow-up instructions, but there was no association observed between race/ethnicity and follow-up instructions received.…”

Section: Introductionmentioning

confidence: 99%

Racial disparities in receipt of survivorship care plans among female cancer survivors in Maryland

Jin,

Jones,

Connor

2024

Front. Cancer Control Soc.

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BackgroundWith the increasing number of cancer survivors in the US, survivorship care plans (SCP) have been promoted to improve survivorship outcomes for cancer patients. Few studies have assessed if the receipt of SCPs differs by race/ethnicity. This study evaluated if racial/ethnic disparities exist in SCP receipt among female cancer survivors living in Maryland.MethodsSurvey data were analyzed for 1,353 non-Hispanic white (NHW) and 280 non-Hispanic Black (NHB) women with a self-reported history of cancer living in Maryland who completed the Maryland Behavioral Risk Factor Surveillance Survey (BRFSS) between 2011 and 2020. Multivariable logistic regression models were used to estimate prevalence odds ratios (PORs) and 95% confidence intervals (CI) for SCP receipt by race/ethnicity. Models were further stratified by demographic, cancer-related, and lifestyle factors to examine effect modification.ResultsOn average, survivors were 66.8 years of age at time of BRFSS survey and 53.5 years of age at time of cancer diagnosis. Compared with NHW survivors, NHB survivors reported higher odds of receiving a summary of cancer treatments (POR = 3.81, 95% CI: 2.27, 6.39), instructions from a doctor for follow-up check-ups (POR = 2.10, 95% CI: 1.00, 4.39), and written or printed instructions (POR = 4.74, 95% CI: 2.12, 10.61). Age at survey (<65 years vs. ≥65 years) (p-interaction term = 0.01) and income level (≤50k vs. >50k) (p-interaction term = 0.04) significantly modified the relationship between race/ethnicity and receiving SCPs.ConclusionOur findings indicate that NHB female cancer survivors in Maryland are more likely to receive SCP information compared to NHW survivors and this association is significantly modified by age at survey and income level. More research is needed at the patient-provider level to gain a better understanding of the impact of SCP delivery to minority cancer populations.

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Disparities in receipt of follow-up care instructions among female adult cancer survivors: Results from a national survey

Cited by 6 publications

References 27 publications

Growing Need for Primary Care Physicians Caring for Cancer Survivors

Growing Need for Primary Care Physicians Caring for Cancer Survivors

A scoping review of the evidence on survivorship care plans among minority, rural, and low-income populations

Racial disparities in receipt of survivorship care plans among female cancer survivors in Maryland

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