Primary care provider involvement in thyroid cancer survivorship care.

Authors

null

Archana Radhakrishnan

University of Michigan, Ann Arbor, MI

Archana Radhakrishnan , David Reyes-Gastelum , Sarah T. Hawley , Ann S. Hamilton , Kevin C. Ward , Lauren P. Wallner , Megan Rist Haymart

Organizations

University of Michigan, Ann Arbor, MI, Department of Preventative Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA, Emory University, Atlanta, GA, University of Michigan Medical School, Ann Arbor, MI, Univ of Michigan Health Syst, Ann Arbor, MI

Research Funding

U.S. National Institutes of Health
U.S. National Institutes of Health

Background: While prior research has examined how primary care providers (PCPs) can help care for breast and colon cancer survivors, little is known about the role of PCPs in thyroid cancer survivorship. We surveyed PCPs to understand their involvement and confidence in providing several aspects of thyroid cancer survivorship care. Methods: Thyroid cancer patients (N = 2632) diagnosed in 2014-2015 and identified from the Georgia and LA SEER registries, were surveyed, and identified their PCPs, who then were also surveyed (N = 162, 56% response rate). PCPs were asked to report their: 1) involvement in thyroid cancer long-term surveillance (not involved: never/rarely vs. involved: sometimes/often/almost always involved); and 2) confidence in handling four aspects of thyroid cancer survivorship care (low: not at all/a little/somewhat vs. high: quite/very confident). We examined PCP factors (individual, practice, attitudes and beliefs) associated with PCP involvement in long-term surveillance using multivariable logistic regression. We then examined associations between PCP involvement in long-term surveillance and PCP confidence in handling the four aspects of thyroid cancer survivorship care using Chi-squared tests. Results: The majority of PCPs (76%) reported involvement in long-term surveillance. Adjusted odds of PCPs reporting involvement was greater among PCPs who somewhat/strongly believed that PCPs have the skills necessary to provide survivorship care (OR 4.33; 95% CI 1.38-15.37), and PCPs who noted clinical guidelines as being the most influential in guiding treatment (OR 4.48; 95% CI 1.67-13.07). PCP reports of high confidence in handling the four aspects of survivorship care were consistently less than 50%: when to refer patient to specialist (40%), role of neck ultrasound (36%), role of random thyroglobulin levels (27%), and when to end long-term surveillance (14%). PCPs who reported involvement in long-term surveillance were more likely to report high confidence in discussing the role of random thyroglobulin levels (33.3% vs. 7.9% for those not involved, p < 0.01) but not the other aspects of survivorship care. Conclusions: Though many PCPs reported they were involved in thyroid cancer long-term surveillance, gaps remain in their confidence in handling several aspects of thyroid cancer survivorship care. Guidelines were noted as important in influencing management; therefore, developing guidelines that specifically delineate PCP roles in thyroid cancer survivorship may present one opportunity to increase PCPs’ confidence about their participation.

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Abstract Details

Meeting

2020 ASCO Virtual Scientific Program

Session Type

Publication Only

Session Title

Publication Only: Care Delivery and Regulatory Policy

Track

Care Delivery and Quality Care

Sub Track

Care Delivery

Citation

J Clin Oncol 38: 2020 (suppl; abstr e14028)

DOI

10.1200/JCO.2020.38.15_suppl.e14028

Abstract #

e14028

Abstract Disclosures

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