Evaluating differences in cancer survivorship care plans experienced by cancer survivors with disabilities.

Authors

null

Hermine Poghosyan

Cancer Outcomes, Public Policy, and Effectiveness Research (COPPER) Center, Yale University, New Haven, CT

Hermine Poghosyan , Sayantani Sarkar

Organizations

Cancer Outcomes, Public Policy, and Effectiveness Research (COPPER) Center, Yale University, New Haven, CT, Yale University School of Nursing, Orange, CT, CT

Research Funding

No funding received
None.

Background: Survivorship Care Plans (SCPs) are crucial elements for short- and long-term follow-up care among cancer survivors and have been endorsed by leading oncologic organizations. Yet, limited research exists about the receipt of SCPs among survivors with disabilities who may face additional barriers to access the health care services. Our study examines the association between the disability status and receipt of SCPs after completion of cancer treatment among US adult cancer survivors. Methods: This secondary analysis included cross-sectional, nationally representative, population-based data from the 2021 Behavioral Risk Factor Surveillance System. We included 2110 respondents (aged ≥ 18 years) who self-reported cancer history (other than skin cancer). Outcomes were self-reported receipt of cancer treatment summaries and follow-up care instructions after completion of the cancer treatment. The independent variable was disability status, comprised of six specific disability types (having serious difficulty with hearing, vision, cognition, mobility, self-care, and independent living). We combined disability status into four groups—as having 1) no disability; 2) one disability; 3) two disabilities; and 4) three or more disabilities. We applied recommended sample weights and conducted weighted descriptive statistics and multivariable logistic regression adjusting for self-reported individual-level factors (age, sex, race, marital status, education, health insurance, provider type who provided majority of the care). Results: Overall, 4.2% self-reported as Black, 19.5% Hispanic, 70.0% White, 59.5% women, and 54.5% aged 65+ years. A total of 20.8% of participants reported having one disability, 11.1% two disabilities, and 11.7% reported three or more disabilities. Mobility disability was the most prevalent disability type (27.0%), followed by cognition (14.8%), independent living (14.5%), hearing (12.7%), vision (9.2%), and self-care (6.5%). About 18.0% did not receive follow-up care instructions, and 41.7% did not receive treatment summaries. Overall, 52.8% of survivors reported receiving both follow-up care instructions and treatment summaries. Survivors with three or more disabilities were 0.40 (95% CI 0.27-0.88, p = 0.019) times significantly less likely to report receiving follow-up care instructions than survivors without disabilities. Survivors’ disability status was not significantly associated with reporting the receipt of cancer treatment summaries. Conclusions: Nearly half of the survivors did not receive SCP upon treatment completion, which may lead to poor treatment adherence and deterioration of health. Our findings suggest disparities in follow-up instructions based on disability status, especially for people with multiple disabilities. Effective strategies are necessary to build more equitable cancer survivorship care.

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Abstract Details

Meeting

2023 ASCO Annual Meeting

Session Type

Publication Only

Session Title

Publication Only: Health Services Research and Quality Improvement

Track

Quality Care/Health Services Research

Sub Track

Access to Care

Citation

J Clin Oncol 41, 2023 (suppl 16; abstr e18597)

DOI

10.1200/JCO.2023.41.16_suppl.e18597

Abstract #

e18597

Abstract Disclosures

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