Demand for oncology visits among low-risk breast cancer survivors.

Authors

null

Emily H. Douglas

Wake Forest University School of Medicine, Winston-Salem, NC

Emily H. Douglas, Alexandra G. Peluso, Aliza Randazzo, Jacqueline Doucette, Alexandra Elmes, J. Bradley Willis, Beth Fisher, Sarah A. Birken

Organizations

Wake Forest University School of Medicine, Winston-Salem, NC, Atrium Health Wake Forest Baptist, Winston-Salem, NC, Oncology Service Line, Atrium Health Wake Forest Baptist, Winston-Salem, NC

Research Funding

Institutional Funding
Wake Forest Baptist Comprehensive Cancer Center, Cancer Prevention and Control Program

Background: The number of breast cancer (BC) survivors in the United States is large and rapidly growing. An unsustainable number of survivors receive care from oncology providers indefinitely, with a disproportionate number of those being white, high socioeconomic women, potentially contributing to disparities in care. Demand for oncology visits among low-risk BC survivors may decrease access to care for more complex, vulnerable survivors and new cancer patients and increase costs without improving quality of care, but has not been quantified. Our study's objective was to quantify demand for oncology visits among low-risk survivors. Methods: We utilized Atrium Health Wake Forest Baptist Comprehensive Cancer Center cancer registry data and electronic medical record data to identify BC survivors with scheduled appointments with an oncology physician from 7/1/2023 to 7/1/2024, excluding patients with Stage IV disease. We defined low-risk BC survivors as those with ductal carcinoma in situ (DCIS) or Stage I BC >5 years from diagnosis, or any survivor >10 years from diagnosis without evidence of recurrence. We used descriptive statistics to quantify demand for oncology visits among low-risk survivors. Results: We identified 877 BC survivors with a scheduled oncology appointment. Of those, 128 (14.5%), were classified as low-risk and possibly transition-eligible, including 50 with DCIS and 66 with Stage I BC >5 years from diagnosis and 57 who were >10 years post-diagnosis. Conclusions: We developed an efficient method to identify low-risk BC survivors actively receiving oncology physician care. While there are limitations, such as incomplete data and lack of analytic support at smaller institutions, this is an adoptable approach to identify survivors eligible for transition of care to an oncology advanced practice provider or primary care provider. Interventions to improve transitions, and thus increase access and quality of oncologic care, must be prioritized in the face of growing numbers of survivors, rapid therapeutic advances, and oncology physician burnout.

Active oncology patients by stage and time from diagnosis.

Stage/Years from Diagnosis Number of Patients
DCIS; 5-10 yrs from dx31
St I; 5-10 yrs from dx40
DCIS/St I-III >10 yrs from dx57
DCIS > 10 yrs from dx19
St I > 10 yrs from dx26
DCIS/St I-III <5 yrs from dx589
St II-III; 5-10 yrs from dx60
Recurrence or missing data100

Abbreviations: Diagnosis (dx), Years (yrs), Stage (St).

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Abstract Details

Meeting

2023 ASCO Quality Care Symposium

Session Type

Poster Session

Session Title

Poster Session A

Track

Quality, Safety, and Implementation Science,Cost, Value, and Policy,Patient Experience,Survivorship

Sub Track

Communication and Transitions

Citation

JCO Oncol Pract 19, 2023 (suppl 11; abstr 490)

DOI

10.1200/OP.2023.19.11_suppl.490

Abstract #

490

Poster Bd #

L16

Abstract Disclosures

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