The unmet needs of cancer survivors and their preferences for discussing them with oncologists and general practitioners (GPs).

Abstract

9602 Background: Cancer survivors experience a range of post-treatment issues which are not well met by current services. This study explores the unmet needs of adult cancer survivors and their levels of comfort in addressing issues with oncologists and GPs. Methods: A cross-sectional survey was mailed to adult cancer survivors 4 years from diagnosis from 6 oncology units. Self-report data were obtained ranking physical, psychological and practical areas of importance to survivors; unmet needs in these areas; and the providers with whom they were happy to discuss each issue. Descriptive statistics were obtained regarding needs and preferences. Univariate and multivariate logistic regression analyses assessed demographic and clinical variables associated with 4 or more unmet care needs. Results: 228 surveys were returned (response rate 50.5%). Respondents had a mean age of 59.3 years (range 32-87), 71.5% were female, with most common primary cancers being breast (71.5%), colorectal (13.9%), prostate (4.5%) and ovarian (2.2%). The most commonly reported unmet needs were information about late effects (50.3%), managing fatigue (41.7 %), genetic risk to family (34.7%), reassurance (32.0 %) and diet (31.4 %). The median number of unmet needs was 4 (range 0-23). On univariate analysis, female gender, younger age and tertiary education were associated with greater unmet needs (p<0.001, p=0.01 and p=0.02). On multivariate analysis higher education (p=0.04) remained independently associated. Conclusions: Cancer survivors report significant unmet care needs, and their comfort levels for discussing them varies between providers. Some key issues are not entrusted to either oncologists or GPs. Models of care for survivors must address these potential deficits in care. [Table: see text]

Cancer survivors’ perspectives of dietary information provision after cancer treatment: A scoping review of the Australian context

“…In the first study, 20 a survey of survivors of various cancer types, participants indicated they preferred to discuss diet with their General Practitioner (GP) rather than their oncologist. However, 51% of participants reported they did not feel comfortable discussing diet with either their GP or oncologist 20 . The survey did not explore the reasons for these preferences, or provide an option for participants to indicate a preference for receiving dietary information from a nutrition professional.…”

“…Cancer survivors’ experiences regarding the provision of dietary information post‐treatment were reported in nine of the 12 included studies 20,22,24,25,27–31 . In eight of these studies, cancer survivors reported that treatment providers often did not provide dietary information post‐treatment or explain the role of diet in recovery from cancer treatment 20,22,25,27–31 .…”

“…Any disagreements were discussed with the research team to reach a consensus. One study 20 that met eligibility criteria but was published in abstract form only was included as per scoping review methodology 16 …”

“…20,22,25,[27][28][29][30][31] In a survey of survivors of various cancer types, 31% identified dietary information as an unmet need posttreatment, ranked fifth highest out of 13 unmet healthcare needs. 20 In a small survey of 20 colorectal cancer survivors, almost half of the participants (45%) had not discussed healthy lifestyle behaviours with their treating team post-treatment, with 67% of these participants indicating that healthy lifestyle information post-treatment would have been helpful. 25 In semi-structured interviews, colorectal cancer survivors without a stoma reported receiving limited dietary support compared to those with a stoma, despite experiencing significant bowel disturbances post-treatment.…”

“…Most study participants had received a combination of surgery, chemotherapy and radiotherapy. 22,[24][25][26][27][28][29] Participants in one study 30 TA B L E 1 Eligibility criteria for study screening four papers 24,27,28,30 and one abstract, 20 and a secondary outcome in seven papers. [21][22][23]25,26,29,31 A summary of cancer survivors' perspectives regarding dietary information provision post-treatment is presented in Table 3.…”