Survivorship care planning and its influence on long-term patient-reported outcomes among colorectal and lung cancer survivors: the CanCORS disease-free survivor follow-up study

Abstract

PURPOSE Evaluate the relationship between survivorship care planning (SCP) and survivorship care and health outcomes reported by long-term lung and colorectal cancer survivors. METHODS Participants (n=832) were diagnosed and enrolled during 2003-2005. In 2012, patient-reported outcomes (survivorship care and health outcomes) and two patient-reported SCP measures (receipt of written summary of cancer treatment and receipt of instructions on who to see for routine cancer follow-up) were collected. Analyses controlled for SCP predictors collected from medical records and an interview 1 year after diagnosis. RESULTS One-in-four survivors reported receiving both SCP elements. Those receiving both were more certain which doctor was in charge (OR 7.0; 95% CI 3.9-12.5), more likely to report follow-up check-ups (OR 5.1; 95% CI 3.3-8.0) and had an MRI/PET/CT scan in the past 2 years (OR 2.8; 95% CI 1.7-4.7) compared to those receiving neither. Physician communication experiences were significantly more positive and having physical exams (OR 2.0; 95% CI 1.2-3.4) and meeting exercise guidelines (OR 1.6; 95% CI 1.004-2.4) more likely. Physical health (p=0.012) and good-to-excellent self-perceived health status (OR 2.2; 95% CI 1.3-3.9) were better for those receiving both elements. CONCLUSION SCP may lead to better cancer follow-up care, long-term physical health, and physician/patient communication experiences. IMPLICATIONS FOR CANCER SURVIVORS The positive association between outcomes and SCP suggest that efforts to implement SCP should be fruitful.

Cancer survivors’ receipt of treatment summaries and implications for patient-centered communication and quality of care

“…Consistent with previous estimates, Health Information National Trends Survey data suggest that receipt of treatment summaries is relatively low, with just over a third of survivors reporting having received these documents at the end of their cancer treatment 10,22,23 . Survivors’ demographic characteristics did not predict receipt of treatment summaries.…”

“…This research adds to the growing, albeit limited, body of evidence that treatment summaries, ideally as part of a comprehensive survivorship care plan, are associated with positive outcomes 10,23 . As new mandates increase the prevalence of treatment summaries 5 , we must continue to carefully examine their impact on clinical communication.…”

“…For many survivors, cancer represents is a “teachable moment” to begin to improve lifestyle and promote healthy living 25 . A study of lung and colorectal cancer survivors from the Cancer Care Outcomes Research and Surveillance Consortium demonstrated that survivors who reported receiving a treatment summary as part of a comprehensive survivorship care plan were more likely to have talked with their doctor about health promotion 23 . However it is important to note that the present analyses cannot distinguish potential pathways by which treatment summaries may improve these functions of PCC or discern whether receiving a treatment summary is simply a marker of patient-centered and high-quality care.…”

Empowering survivors after colorectal and lung cancer treatment: Pilot study of a Self-Management Survivorship Care Planning intervention

“…Integrating self-management coaching and its principles to communicate TS/CP content may help to alleviate uncertainty and promote a sense of control (Baravelli et al, 2009). Findings from the Cancer Care Outcomes Research and Surveillance Consortium (CanCORS) study of long-term colorectal and lung cancer survivors suggest that survivors who received care planning were more likely to have positive self-efficacy and to have seen a physician for follow-up care (Chrischilles et al, 2015). …”

“…However, other studies found that CRC survivors experience significant levels of anxiety and distress (D’Souza et al, 2016). Studies show that SCP may lead to improved follow-up care, better long-term physical well-being, positive self-efficacy, improved survivor knowledge on survivorship care, and positive lifestyle changes (Chrischilles et al, 2015; Klemanski et al, 2016; Nissen et al, 2013). The qualitative data also provided support for improved self-efficacy and confidence in understanding their health plan going forward.…”