Developing an integrated survivorship checklist for LMIC: Feasibility and results from a tertiary care center.

Abstract

e24135 Background: Survivorship clinics are vital for identifying health and quality-of-life issues among cancer survivors (CS). However, these clinics are a novelty in LMIC, with little structural anatomy and a sketchy referral system. We developed a comprehensive survivorship checklist to identify major survivorship issues and ensure streamlined multidisciplinary referrals in a single visit. Methods: Our survivorship clinic was established in September 2025. A structured checklist covering demographic details, physical and psychosocial issues, financial toxicity and unmet needs in CS was created, using validated scoring scales in alignment with the NCCN survivorship guidelines across 26 domains. Data was collected by a trained psychological counsellor, and all patients were referred based on their prioritising needs. Results: 85 CS were evaluated.68.2% were males, and 66.2% were post-treatment completion. Among those on active treatment, 35.29% received multimodality treatment. Head and neck cancers (35.2%) and breast cancer (11.8%) were the most common diagnoses. Mean time since diagnosis was 25.89 months.33.2% patients admitted having a history of substance abuse (tobacco 24.5%). The mean scores were NCCN distress scale (3.76), GAD 7 (4.16) and PHQ 9(5.38). Fertility concerns were noted in 12.9%, and sexual health issues in 29.6%. The average fatigue score was 3.55; the mean sleep duration was 6.18 hours, with 22.55 % reporting poor sleep quality.75.3% patients were engaged in some form of physical activity ( 45.3% exercising daily). Peripheral neuropathy (37.64%) and generalised weakness (34.11%) were the most common physical symptoms reported.27.11% of breast cancer patients had lymphoedema. Mean WHO-5 well-being index scoring was 67.27%. All patients were referred to the primary treating physicians with the physical/psychosocial issues highlighted. Referrals include psychology (69.4%), physical rehabilitation (26.6%), endocrinology (21.7%), psychiatry/De-addiction (18.8%), sleep clinic (14%), assisted reproduction (11.8%) and pain services (9.4%). All patients reported mild to moderate financial toxicity using the COST FACIT scale, mainly due to accommodation (78.8%) and travel (69.4%). Impact of cancer on life perspective was the most common unmet need(31.7%). All patients received non-pharmacological interventions like yoga, dietician consult and counselling. Conclusions: This checklist helped us identify physical, emotional, and social problems in CS and ensured timely referral to the concerned specialist in a single visit. Although completing the form was initially time-consuming, the process became smoother with regular use and staff familiarity. With further validation and long-term follow-up, this checklist has the potential to become a practical, low-cost model for strengthening survivorship care in LMIC.