Assessing the current state of cancer survivorship care and barriers at an NCI-designated cancer center.

Abstract

e13875 Background: Cancer survivorship care is complex and challenging to deliver. The current state of cancer survivorship within the University of Wisconsin Carbone Cancer Center (UWCCC) is not well understood, and every disease group has an independent approach. We aimed to survey the disease-specific clinics at UWCCC to understand the gaps and barriers to survivorship care. Methods: We designed an electronic survey asking about the current approach to survivorship care. This included demographics, practice location and disease-group of the responder, survivorship issues addressed routinely in clinic and if they had a dedicated survivorship clinic. For responders with a survivorship clinic, details of timing, frequency, model, specialties involved were collected. For responders without a dedicated survivorship clinic, we collected information about ongoing survivorship efforts, barriers, survivorship focused care provided in follow-up visits and referral to other specialties. The survey results were summarized. Interested participants also underwent structured recorded interviews, and the transcripts qualitatively analyzed for common themes. Results: We received survey responses from 52 out of 195 (27%) UWCCC providers. Of the responders, 62.8% were physicians, 35.5% APPs, and 2% RNs spanning surgical, radiation, gynecologic, pediatric and adult medical oncology. 25% responders reported having a dedicated survivorship clinic (for breast, pediatric, adolescent and young adult, hereditary cancers), while 65% did not and 10% did not know. Many aspects of survivorship care were routinely addressed by responders both with and without a dedicated survivorship clinic (Table). We have conducted 6 interviews without achieving thematic saturation and further interviews are ongoing with results to be included in the presentation. Conclusions: We found most disease groups at UWCCC do not have dedicated survivorship clinics or care models. However, nearly all survey respondents indicated that they address aspects of survivorship care within their current practice, although it is not recognized as such. Our next steps are to share this data with the UWCCC leadership to develop priorities for building a comprehensive survivorship program. Dedicated Survivorship Clinic Yes (n=13) (%) No (n=32) (%) I do not know (n=5) (%) Risk of disease recurrence (n=45) 84.6 93.8 80.0 Survivors’ functional capacity and treatment-related side-effects (n=41) 84.6 81.3 80.0 Surveillance and management of psychosocial effects (n=34) 84.6 62.5 60.0 Risk of subsequent/secondary cancers (n=34) 76.9 68.8 40.0 Tobacco cessation (n=31) 61.5 65.6 40.0 Exercise and weight management (n=30) 76.9 53.1 60.0 Fertility preservation, reproductive and sexual health concerns (n=30) 84.6 53.1 40.0 PROs, including quality of life and survivorship experiences (n=27) 76.9 46.9 40.0 Access to peer support (n=27) 84.6 40.6 60.0