Variations in recommended surveillance in colorectal cancer survivorship care plans.

Authors

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Alaina Chodoff

Johns Hopkins, Baltimore, MD

Alaina Chodoff, Katherine Clegg Smith, Aishwarya Shukla, Amanda L. Blackford, Nita Ahuja, Fabian McCartney Johnston, Kimberly S. Peairs, Justinian R. Ngaiza, Tam Warczynski, Brenda Nettles, Eden Stotsky-Himelfarb, Adrian Gerard Murphy, Nancy Mayonado, Jennifer DeSanto, Claire Frances Snyder, Youngjee Choi

Organizations

Johns Hopkins, Baltimore, MD, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, Johns Hopkins School of Medicine, Baltimore, MD, The Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins University, Baltimore, MD, Johns Hopkins University School of Medicine, Baltimore, MD, Department of Surgery, Johns Hopkins University, Baltimore, MD, Johns Hopkins Medicine, Baltimore, MD, Peninsula Reg Onc, Salisbury, MD, Johns Hopkins Hospital and Health System, Baltimore, MD, Johns Hopkins Hospital, Baltimore, MD, The Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Baltimore, Johns Hopkins Sidney Kimmel Comprehensive Cancer Center, Baltimore, MD, Richard A. Henson Research Institute, Peninsula Regional Medical Center, Salisury, MD, Johns Hopkins University, Baltimore

Research Funding

Other
Patient-Centered Outcomes Research Institute.

Background: Survivorship care plans (SCPs) outline pertinent information about a cancer survivor’s treatment and follow-up care. We describe the content of colorectal cancer (CRC) SCPs, completed as part of a randomized controlled trial of SCPs, and evaluate whether follow-up recommendations are guideline concordant. Methods: We analyzed 74 CRC SCPs from an academic and community cancer center. Frequency distributions and descriptive statistics were calculated for the entire cohort and separately by recruiting site. Follow-up recommendations were compared to American Cancer Society (ACS), American Society of Clinical Oncology (ASCO) and National Comprehensive Cancer Network (NCCN) guidelines (Table). Results: Content routinely provided in SCPs (>80%) included patient demographics, cancer diagnosis, treatment details (surgery, chemotherapy, radiation therapy) as well as treatment-related side effects. SCP content specified less frequently included cancer stage, cancer risk (predisposing conditions), and recommendations for genetic counseling/testing and health promotion. Nearly all SCPs from the community site provided uniform, guideline-concordant follow-up. At the academic site, on average, more than 15 follow-up recommendations were listed for each surveillance modality, except colonoscopy. Among the SCPs that specified the frequency of follow-up care, the rate of guideline-concordant recommendations was 15/42 (36%) for follow-up visits, 29/43 (67%) for imaging, 12/45 (27%) for laboratory and 39/39 (100%) for colonoscopy. Conclusions: SCPs consistently provided information about CRC diagnosis and treatment, but often omitted information about cancer risk, staging and prognosis. There was considerable variation between cancer centers in the follow-up recommendations suggested for CRC survivors. Future work to improve the consistency of SCP follow-up recommendations with guidelines may be needed. Clinical trial information: NCT03035773.

Post-treatment expert consensus surveillance guidelines.

Follow-up VisitCarcinoembryonic antigenCT scanColonoscopy
ASCOY1-5Q3-6 moY1-5Q3-6 moY1-3Q12 moY1*
ACSY1-2Q3-6 moY1-2Q3-6 moY1-5Q12 moY1*
NCCNY3-5Q6 moY3-5Q6 moY1-5^Q6-12 moY1*

Q: every; Y: years; mo: months *Repeat based on findings (may differ for patients with rectal cancer) ^ For rectal cancer, CT scan Q3-6 mo Y1-2, Q6-12 mo Y3-5

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Abstract Details

Meeting

2020 ASCO Quality Care Symposium

Session Type

Poster Session

Session Title

On-Demand Poster Session: Cost, Value, and Policy

Track

Cost, Value, and Policy

Sub Track

Guideline-Concordant Care Initiatives

Clinical Trial Registration Number

NCT03035773

Citation

J Clin Oncol 38, 2020 (suppl 29; abstr 13)

DOI

10.1200/JCO.2020.38.29_suppl.13

Abstract #

13

Poster Bd #

Online Only

Abstract Disclosures