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Erschienen in: Journal of Cancer Survivorship 3/2017

30.12.2016

Young adult cancer survivors’ follow-up care expectations of oncologists and primary care physicians

verfasst von: Kiara Hugh-Yeun, Divjot Kumar, Ali Moghaddamjou, Jenny Y. Ruan, Winson Y. Cheung

Erschienen in: Journal of Cancer Survivorship | Ausgabe 3/2017

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Abstract

Purpose

Young adult cancer survivors face unique challenges associated with their illness. While both oncologists and primary care physicians (PCPs) may be involved in the follow-up care of these cancer survivors, we hypothesized that there is a lack of clarity regarding each physician’s roles and responsibilities.

Methods

A self-administered survey was mailed to young adult cancer survivors in British Columbia, Canada, who were aged 20 to 39 years at the time of diagnosis and alive at 2 to 5 years following the diagnosis to capture their expectations of oncologists and PCPs in various important domains of cancer survivorship care. Multivariate logistic regression models that adjusted for confounders were constructed to examine for predictors of the different expectations.

Results

Of 722 young cancer survivors surveyed, 426 (59%) responded. Among them, the majority were White women with breast cancer. Oncologists were expected to follow the patient’s most recent cancer and treatment-related side effects while PCPs were expected to manage ongoing and future cancer surveillance as well as general preventative care. Neither physician was perceived to be responsible for addressing the return to daily activities, reintegration to interpersonal relationships, or sexual function. Older survivors were significantly less likely to expect oncologists (p = 0.03) and PCPs (p = 0.01) to discuss family planning when compared to their younger counterparts. Those who were White were significantly more likely to expect PCPs to discuss comorbidities (p = 0.009) and preventative care (p = 0.001).

Conclusions

Young adult cancer survivors have different expectations of oncologists and PCPs with respect to their follow-up care. Physicians need to better clarify their roles in order to further improve the survivorship phase of cancer care for young adults.

Implications for Cancer Survivors

Young adult cancer survivors have different expectations of their oncologists and PCPs. Clarification of the roles of each physician group during follow-up can enhance the quality of survivorship care for young adults.
Literatur
1.
Zurück zum Zitat Jemal A, Bray F, Center MM, Ferlay J, Ward E, Forman D. Global cancer statistics. CA Cancer J Clin. 2011;61:69–90.CrossRefPubMed Jemal A, Bray F, Center MM, Ferlay J, Ward E, Forman D. Global cancer statistics. CA Cancer J Clin. 2011;61:69–90.CrossRefPubMed
2.
Zurück zum Zitat Fisher B, Anderson S, Redmond CK, Wolmark N, Wickerham DL, Cronin WM. Reanalysis and results after 12 years of follow-up in a randomized clinical trial comparing total mastectomy with lumpectomy with or without irradiation in the treatment of breast cancer. N Engl J Med. 1995;333:1456–61.CrossRefPubMed Fisher B, Anderson S, Redmond CK, Wolmark N, Wickerham DL, Cronin WM. Reanalysis and results after 12 years of follow-up in a randomized clinical trial comparing total mastectomy with lumpectomy with or without irradiation in the treatment of breast cancer. N Engl J Med. 1995;333:1456–61.CrossRefPubMed
3.
Zurück zum Zitat Ganz PA, Desmond KA, Leedham B, Rowland JH, Meyerowitz BE, Belin TR. Quality of life in long-term, disease-free survivors of breast cancer: a follow-up study. J Natl Cancer Inst. 2002;94:39–49.CrossRefPubMed Ganz PA, Desmond KA, Leedham B, Rowland JH, Meyerowitz BE, Belin TR. Quality of life in long-term, disease-free survivors of breast cancer: a follow-up study. J Natl Cancer Inst. 2002;94:39–49.CrossRefPubMed
4.
Zurück zum Zitat Grunfeld E, Levine MN, Julian JA, et al. Randomized trial of long-term follow-up for early-stage breast cancer: a comparison of family physician versus specialist care. J Clin Oncol. 2006;24:848–55.CrossRefPubMed Grunfeld E, Levine MN, Julian JA, et al. Randomized trial of long-term follow-up for early-stage breast cancer: a comparison of family physician versus specialist care. J Clin Oncol. 2006;24:848–55.CrossRefPubMed
5.
Zurück zum Zitat Cheung WY, Neville BA, Cameron DB, Cook EF, Earle CC. Comparisons of patient and physician expectations for cancer survivorship care. J Clin Oncol. 2009;27:2489–95.CrossRefPubMed Cheung WY, Neville BA, Cameron DB, Cook EF, Earle CC. Comparisons of patient and physician expectations for cancer survivorship care. J Clin Oncol. 2009;27:2489–95.CrossRefPubMed
6.
Zurück zum Zitat Michel G, Greenfield DM, Absolom K, et al. Follow-up care after childhood cancer: survivors’ expectations and preferences for care. Eur J Cancer. 2009;45:1616–23.CrossRefPubMed Michel G, Greenfield DM, Absolom K, et al. Follow-up care after childhood cancer: survivors’ expectations and preferences for care. Eur J Cancer. 2009;45:1616–23.CrossRefPubMed
7.
Zurück zum Zitat Rowland JH, Hewitt M, Ganz PA. Cancer survivorship: a new challenge in delivering quality cancer care. J Clin Oncol. 2006;24:5101–4.CrossRefPubMed Rowland JH, Hewitt M, Ganz PA. Cancer survivorship: a new challenge in delivering quality cancer care. J Clin Oncol. 2006;24:5101–4.CrossRefPubMed
8.
Zurück zum Zitat Bleyer WA. Cancer in older adolescents and young adults: epidemiology, diagnosis, treatment, survival, and importance of clinical trials. Med Pediatr Oncol. 2002;38:1–10.CrossRefPubMed Bleyer WA. Cancer in older adolescents and young adults: epidemiology, diagnosis, treatment, survival, and importance of clinical trials. Med Pediatr Oncol. 2002;38:1–10.CrossRefPubMed
9.
Zurück zum Zitat Burke ME, Albritton K, Marina N. Challenges in the recruitment of adolescents and young adults to cancer clinical trials. Cancer. 2007;110:2385–93.CrossRefPubMed Burke ME, Albritton K, Marina N. Challenges in the recruitment of adolescents and young adults to cancer clinical trials. Cancer. 2007;110:2385–93.CrossRefPubMed
10.
Zurück zum Zitat Zebrack B. Information and service needs for young adult cancer survivors. Support Care Cancer. 2009;17:349–57.CrossRefPubMed Zebrack B. Information and service needs for young adult cancer survivors. Support Care Cancer. 2009;17:349–57.CrossRefPubMed
11.
Zurück zum Zitat Earle CC. Failing to plan is planning to fail: improving the quality of care with survivorship care plans. J Clin Oncol. 2006;24:5112–6.CrossRefPubMed Earle CC. Failing to plan is planning to fail: improving the quality of care with survivorship care plans. J Clin Oncol. 2006;24:5112–6.CrossRefPubMed
12.
Zurück zum Zitat Foster C, Wright D, Hill H, Hopkinson J, Roffe L. Psychosocial implications of living 5 years or more following a cancer diagnosis: a systematic review of the research evidence. Eur J Cancer Care (Engl). 2009;18:223–47.CrossRef Foster C, Wright D, Hill H, Hopkinson J, Roffe L. Psychosocial implications of living 5 years or more following a cancer diagnosis: a systematic review of the research evidence. Eur J Cancer Care (Engl). 2009;18:223–47.CrossRef
13.
Zurück zum Zitat Oncology ASoC. Status of the medical oncology workforce. J Clin Oncol. 1996;14:2612–21.CrossRef Oncology ASoC. Status of the medical oncology workforce. J Clin Oncol. 1996;14:2612–21.CrossRef
14.
Zurück zum Zitat Del Giudice ME, Grunfeld E, Harvey BJ, Piliotis E, Verma S. Primary care physicians’ views of routine follow-up care of cancer survivors. J Clin Oncol. 2009;27:3338–45.CrossRefPubMed Del Giudice ME, Grunfeld E, Harvey BJ, Piliotis E, Verma S. Primary care physicians’ views of routine follow-up care of cancer survivors. J Clin Oncol. 2009;27:3338–45.CrossRefPubMed
15.
Zurück zum Zitat Alfano CM, Rowland JH. Recovery issues in cancer survivorship: a new challenge for supportive care. Cancer J. 2006;12:432–43.CrossRefPubMed Alfano CM, Rowland JH. Recovery issues in cancer survivorship: a new challenge for supportive care. Cancer J. 2006;12:432–43.CrossRefPubMed
16.
Zurück zum Zitat Bleyer A, Budd T, Montello M. Adolescents and young adults with cancer: the scope of the problem and criticality of clinical trials. Cancer. 2006;107:1645–55.CrossRefPubMed Bleyer A, Budd T, Montello M. Adolescents and young adults with cancer: the scope of the problem and criticality of clinical trials. Cancer. 2006;107:1645–55.CrossRefPubMed
17.
Zurück zum Zitat Zebrack B, Bleyer A, Albritton K, Medearis S, Tang J. Assessing the health care needs of adolescent and young adult cancer patients and survivors. Cancer. 2006;107:2915–23.CrossRefPubMed Zebrack B, Bleyer A, Albritton K, Medearis S, Tang J. Assessing the health care needs of adolescent and young adult cancer patients and survivors. Cancer. 2006;107:2915–23.CrossRefPubMed
18.
Zurück zum Zitat Earle CC, Neville BA. Under use of necessary care among cancer survivors. Cancer. 2004;101:1712–9.CrossRefPubMed Earle CC, Neville BA. Under use of necessary care among cancer survivors. Cancer. 2004;101:1712–9.CrossRefPubMed
19.
Zurück zum Zitat Mao JJ, Bowman MA, Stricker CT, et al. Delivery of survivorship care by primary care physicians: the perspective of breast cancer patients. J Clin Oncol. 2009;27:933–8.CrossRefPubMed Mao JJ, Bowman MA, Stricker CT, et al. Delivery of survivorship care by primary care physicians: the perspective of breast cancer patients. J Clin Oncol. 2009;27:933–8.CrossRefPubMed
20.
Zurück zum Zitat Saha S, Arbelaez JJ, Cooper LA. Patient-physician relationships and racial disparities in the quality of health care. Am J Public Health. 2003;93:1713–9.CrossRefPubMedPubMedCentral Saha S, Arbelaez JJ, Cooper LA. Patient-physician relationships and racial disparities in the quality of health care. Am J Public Health. 2003;93:1713–9.CrossRefPubMedPubMedCentral
21.
Zurück zum Zitat Aziz NM, Rowland JH. Cancer survivorship research among ethnic minority and medically underserved groups. Oncol Nurs Forum. 2002;29:789–801.CrossRefPubMed Aziz NM, Rowland JH. Cancer survivorship research among ethnic minority and medically underserved groups. Oncol Nurs Forum. 2002;29:789–801.CrossRefPubMed
22.
Zurück zum Zitat Ayanian JZ, Zaslavsky AM, Guadagnoli E, et al. Patients’ perceptions of quality of care for colorectal cancer by race, ethnicity, and language. J Clin Oncol. 2005;23:6576–86.CrossRefPubMed Ayanian JZ, Zaslavsky AM, Guadagnoli E, et al. Patients’ perceptions of quality of care for colorectal cancer by race, ethnicity, and language. J Clin Oncol. 2005;23:6576–86.CrossRefPubMed
23.
Zurück zum Zitat Coccia PF, Altman J, Bhatia S, et al. Adolescent and young adult oncology. Clinical practice guidelines in oncology. J Natl Compr Cancer Netw. 2012;10:1112–50.CrossRef Coccia PF, Altman J, Bhatia S, et al. Adolescent and young adult oncology. Clinical practice guidelines in oncology. J Natl Compr Cancer Netw. 2012;10:1112–50.CrossRef
24.
Zurück zum Zitat Zebrack B, Isaacson S. Psychosocial care of adolescent and young adult patients with cancer and survivors. J Clin Oncol. 2012;30:1221–6.CrossRefPubMed Zebrack B, Isaacson S. Psychosocial care of adolescent and young adult patients with cancer and survivors. J Clin Oncol. 2012;30:1221–6.CrossRefPubMed
25.
Zurück zum Zitat Flynn KE, Reese JB, Jeffery DD, et al. Patient experiences with communication about sex during and after treatment for cancer. Psychooncology. 2012;21:594–601.CrossRefPubMed Flynn KE, Reese JB, Jeffery DD, et al. Patient experiences with communication about sex during and after treatment for cancer. Psychooncology. 2012;21:594–601.CrossRefPubMed
26.
Zurück zum Zitat Hewitt ME, Bamundo A, Day R, Harvey C. Perspectives on post-treatment cancer care: qualitative research with survivors, nurses, and physicians. J Clin Oncol. 2007;25:2270–3.CrossRefPubMed Hewitt ME, Bamundo A, Day R, Harvey C. Perspectives on post-treatment cancer care: qualitative research with survivors, nurses, and physicians. J Clin Oncol. 2007;25:2270–3.CrossRefPubMed
27.
Zurück zum Zitat Zitzelsberger L, Grunfeld E, Graham ID. Family physicians’ perspectives on practice guidelines related to cancer control. BMC Fam Pract. 2004;5:25.CrossRefPubMedPubMedCentral Zitzelsberger L, Grunfeld E, Graham ID. Family physicians’ perspectives on practice guidelines related to cancer control. BMC Fam Pract. 2004;5:25.CrossRefPubMedPubMedCentral
28.
Zurück zum Zitat Quinn GP, Vadaparampil ST, Lee JH, et al. Physician referral for fertility preservation in oncology patients: a national study of practice behaviors. J Clin Oncol. 2009;27:5952–7.CrossRefPubMed Quinn GP, Vadaparampil ST, Lee JH, et al. Physician referral for fertility preservation in oncology patients: a national study of practice behaviors. J Clin Oncol. 2009;27:5952–7.CrossRefPubMed
29.
Zurück zum Zitat Schover LR, Rybicki LA, Martin BA, Bringelsen KA. Having children after cancer. A pilot survey of survivors’ attitudes and experiences. Cancer. 1999;86:697–709.CrossRefPubMed Schover LR, Rybicki LA, Martin BA, Bringelsen KA. Having children after cancer. A pilot survey of survivors’ attitudes and experiences. Cancer. 1999;86:697–709.CrossRefPubMed
30.
Zurück zum Zitat Oeffinger KC, McCabe MS. Models for delivering survivorship care. J Clin Oncol. 2006;24:5117–24.CrossRefPubMed Oeffinger KC, McCabe MS. Models for delivering survivorship care. J Clin Oncol. 2006;24:5117–24.CrossRefPubMed
31.
Zurück zum Zitat Nathan PC, Hayes-Lattin B, Sisler JJ, Hudson MM. Critical issues in transition and survivorship for adolescents and young adults with cancers. Cancer. 2011;117:2335–41.CrossRefPubMed Nathan PC, Hayes-Lattin B, Sisler JJ, Hudson MM. Critical issues in transition and survivorship for adolescents and young adults with cancers. Cancer. 2011;117:2335–41.CrossRefPubMed
Metadaten
Titel
Young adult cancer survivors’ follow-up care expectations of oncologists and primary care physicians
verfasst von
Kiara Hugh-Yeun
Divjot Kumar
Ali Moghaddamjou
Jenny Y. Ruan
Winson Y. Cheung
Publikationsdatum
30.12.2016
Verlag
Springer US
Erschienen in
Journal of Cancer Survivorship / Ausgabe 3/2017
Print ISSN: 1932-2259
Elektronische ISSN: 1932-2267
DOI
https://doi.org/10.1007/s11764-016-0587-7

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