Article Figures & Data
Figures
- Figure 1
(A) Use of guidelines that include recommendations for surveillance of cancer recurrence from national medical organizations, Porter Novelli DocStyles survey, 2019. (B) Use of comprehensive cancer survivorship care guidelines from national medical organizations, Porter Novelli DocStyles survey, 2019.
Tables
- Table 1.
Characteristics of Providers and Use of Guidelines for Surveillance for Cancer Recurrence and Survivorship Care, 2019 Porter Novelli DocStyles Survey
Total (n = 1421) Providers Using Surveillance Guidelines (n = 1116)* Providers Using Guidelines for Comprehensive Survivorship Care (n = 878)* Providers Using Neither Type of Guideline, “non-users” (n = 254) n % %, P value† %, P value† %, P value† Total 78.5 61.8 17.9 Gender P = .369 P = .635 P = .279 Man 847 59.6 77.5 62.6 19.1 Woman 574 40.4 80.1 60.6 16.0 Age group (years) P = .028 P = .310 P = .044 <40 305 21.5 85.6 67.2 12.1 40–49 461 32.4 76.6 60.1 20.2 50–64 547 38.5 76.1 60.3 19.7 65+ 108 7.6 79.6 61.1 14.8 Race/ethnicity P = .710 P = .286 P = .843 Hispanic or Latino 63 4.4 81.0 68.3 19.1 White (non-Hispanic) 961 67.6 77.2 59.6 18.7 Black/African American 46 3.2 82.6 69.6 13.0 Asian/Pacific Islander 291 20.5 81.1 66.3 15.8 Other (American Indian/Alaska Native, multiracial, other) 60 4.2 81.7 61.7 16.7 Number of survivors seen per week P = .279 P = .031 P = .419 <1 312 22.0 75.3 57.7 19.6 1–15 831 58.5 79.4 61.6 17.5 16–30 209 14.7 77.0 62.7 19.6 31+ 69 4.9 87.0 79.7 10.1 Provider type P = .001 P = .055 P = .001 Family physician 401 28.2 78.3 61.1 18.7 Internist 563 39.6 72.3 62.7 22.6 OBGYN 239 16.8 91.2 54.8 7.5 Nurse practitioner 122 8.6 81.2 73.0 13.9 Physician assistant 96 6.8 81.3 62.5 17.7 Region P = .867 P = .720 P = .934 Northeast 353 24.8 76.8 63.2 18.7 Midwest 302 21.3 78.8 58.6 16.9 South 479 33.7 79.5 61.6 18.2 West 287 20.2 78.8 63.8 17.4 Years in practice P = .302 P = .482 P = .482 3 to 9 288 20.3 83.3 63.9 14.9 10 to 19 522 36.7 77.8 62.8 17.8 20 to 29 403 28.4 76.9 58.1 20.4 30+ 208 14.6 76.9 63.5 17.3 Privileges at a teaching hospital P = .105 P = .279 P = .185 Yes 698 49.1 80.8 63.8 16.1 No 723 50.9 76.4 59.9 19.6 Financial status of patients P = .846 P = .039 P = .843 Poor (Less than $25,000) 96 6.8 75.0 54.2 20.8 Lower middle ($25,000 – $49,999) 348 24.5 80.2 58.3 18.4 Middle ($50,000–$99,999) 589 41.5 78.1 60.4 18.2 Upper middle ($100,000 – $249,999) 272 19.1 77.6 69.5 17.3 Affluent ($250,000 or more) 116 8.2 81.0 67.2 13.8 Work setting P = .934 P = .722 P = .867 Individual outpatient 286 20.1 77.6 62.9 18.2 Group outpatient 922 64.9 78.4 60.9 17.5 Inpatient practice 213 15.0 78.9 64.3 19.3 Refer to survivorship care plan P = .001 P = .001 P = .001 Always/often 374 26.3 73.3 48.9 23.3 Sometimes 481 33.9 85.0 73.8 10.6 Rarely/never 313 22.0 91.1 80.5 7.7 Not applicable 253 17.8 58.5 34.8 36.4 Received survivorship care training P = .001 P = .001 P = .001 Yes 247 17.4 91.9 84.6 4.9 No 1037 73.0 75.7 56.8 20.4 Don't know/not sure 137 9.6 75.9 58.4 21.9 *Providers who used guidelines for surveillance of cancer recurrence are not mutually exclusive from providers who reported using comprehensive cancer survivorship care guidelines.
P values compare providers using each guideline category to providers who reported not using them (data not shown).
†P values adjusted for false discovery rate.
- Table 2.
Types of Survivorship Care Provided by Survivorship Care Guideline Use and Training, 2019 Porter Novelli DocStyles Survey
Care Provided (%, P value*) Treating Depression Surveillance for Recurrence Screening for New Cancer Assessing Late/Long Term Effects Treating Pain Treating Fatigue Treating Sexual Dysfunction Counseling on Diet/Physical Activity Counseling on Tobacco Cessation Assessing Genetic Risk None of these Services Provided Total 62.2 56.7 52.0 40.5 41.1 40.6 39.6 58.8 66.3 25.6 9.0 Use surveillance guidelines Yes (n = 1116) 64.2 60.6 54.0 41.9 42.9 42.0 42.7 60.6 68.5 29.2 6.0 No (n = 305) 55.1 42.6 44.6 35.4 34.4 35.4 28.5 52.1 58.4 12.5 20.0 P value 0.005 <0.001 0.005 0.042 0.01 0.041 <0.001 0.01 0.002 <0.001 <0.001 Use comprehensive survivorship care guidelines Yes (n = 878) 65.6 62.6 55.4 45.4 45.4 44.7 42.6 62.1 69.9 29.2 3.9 No (n = 543) 56.7 47.2 46.6 32.6 34.1 34.1 34.8 53.4 60.4 19.9 17.3 P value 0.002 <0.001 0.002 <0.001 <0.001 <0.001 0.005 0.002 <0.001 <0.001 <0.001 Survivorship training Yes (n = 247) 69.6 66.0 56.7 59.9 57.9 55.1 49.8 65.2 68.8 37.7 1.2 No (n = 1037) 61.1 54.7 51.6 36.4 37.6 37.1 37.8 57.2 66.4 23.1 10.1 P value 0.015 0.002 0.155 <0.001 <0.001 <0.001 0.001 0.025 0.474 < .001 < .001 ↵*Adjusted P values to account for false discovery rate.
- Table 3.
Confidence in Providing Survivorship Care by Survivorship Care Guideline Use and Training, 2019 Porter Novelli DocStyles Survey
Confidence in providing care* (%, P value±) Treating Depression Surveillance for Recurrence Screening for New Cancer Assessing Late/Long Term Effects Treating Pain Treating Fatigue Treating Sexual Dysfunction Total (n = 1377) 77.0 65.3 76.9 58.3 58.2 60.1 60.0 Use surveillance guidelines Yes (n = 1073) 77.6 68.2 78.7 60.6 60.9 62.9 62.5 No (n = 286) 74.7 54.0 70.0 49.8 47.9 49.7 50.9 P value 0.285 <0.001 0.003 0.001 <0.001 <0.001 0.001 Use comprehensive survivorship care guidelines Yes (n = 865) 80.6 70.6 79.3 64.9 65.3 66.6 63.4 No (n = 512) 71.0 56.3 72.9 47.1 46.1 49.3 54.4 P value <0.001 <0.001 0.01 <0.001 <0.001 <0.001 0.001 Survivorship training Yes (n = 247) 82.7 77.3 81.3 75.8 71.4 72.4 66.7 No (n = 996) 75.2 61.9 75.7 53.6 54.2 56.0 57.9 P value 0.014 <0.001 0.063 <0.001 <0.001 <0.001 0.014 *Very confident/moderately confident versus somewhat/not at all confident.
±Adjusted P values to account for false discovery rate.
- Table 4.
Predictors of Providing Survivorship Care by Topic Area, 2019 Porter Novelli DocStyles Survey
Smoking Cessation Counseling* Treating Depression† Surveillance for Recurrence‡ Screening for New Cancer§ Assessing Late/Long Term Treatment Effects|| Diet/Physical Activity Counseling† Treating Pain|| Treating Fatigue† Treating Sexual Dysfunction¶ Assessing Genetic Risk§ Predictor AOR, 95% CI AOR, 95% CI AOR, 95% CI AOR, 95% CI AOR, 95% CI AOR, 95% CI AOR, 95% CI AOR, 95% CI AOR, 95% CI AOR, 95% CI Provider type Family physician 1.69 (1.23, 2.32) 2.08 (1.52, 2.84) 0.80 (0.60, 1.08) 1.04 (0.78, 1.38) 1.04 (0.79, 1.38) 1.57 (1.17, 2.10) 0.99 (0.75, 1.31) 1.36 (1.03, 1.79) 1.47 (1.09, 1.98) 0.92 (0.65, 1.29) Internist ref ref ref ref ref ref ref ref ref ref OBGYN 0.44 (0.31, 0.63) 0.36 (0.26, 0.52) 0.90 (0.63, 1.28) 0.81 (0.57, 1.14) 0.24 (0.16, 0.36) 0.47 (0.33, 0.67) 0.15 (0.09, 0.23) 0.19 (0.12, 0.29) 5.42 (3.73, 7.88) 2.22 (1.53, 3.22) Nurse practitioner 1.17 (0.70, 1.93) 0.78 (0.49, 1.25) 0.81 (0.52, 1.27) 0.48 (0.30, 0.76) 1.32 (0.85, 2.05) 1.14 (0.71, 1.83) 0.51 (0.32, 0.79) 1.03 (0.65, 1.63) 1.13 (0.71, 1.78) 0.79 (0.47, 1.34) Physician Assistant 0.51 (0.31, 0.85) 0.51 (0.31, 0.84) 0.73 (0.45, 1.20) 0.45 (0.27, 0.74) 0.84 (0.51, 1.38) 0.38 (0.23, 0.63) 0.39 (0.23, 0.66) 0.57 (0.34, 0.96) 0.67 (0.38, 1.19) 0.82 (0.45, 1.50) Use of anyguidelines Yes 1.59 (1.15, 2.20) 1.64 (1.20, 2.25) 2.32 (1.70, 3.18) 1.63 (1.20, 2.22) 1.43 (1.04, 1.98) 1.52 (1.12, 2.08) 1.49 (1.08, 2.05) 1.34 (0.98, 1.84) 1.42 (1.01, 1.99) 2.65 (1.68, 4.17) No ref ref ref ref ref ref ref ref ref ref Survivorshipcare training Yes 0.96 (0.69, 1.33) 1.34 (0.97, 1.85) 1.48 (1.08, 2.03) 1.20 (0.89, 1.62) 2.30 (1.69, 3.12) 1.28 (0.94, 1.75) 1.89 (1.39, 2.57) 1.90 (1.40, 2.58) 1.95 (1.43, 2.67) 2.06 (1.49, 2.86) No ref ref ref ref ref ref ref ref ref ref *Models were adjusted for the following demographic and clinical characteristics: years in practice, provider type, gender, number of cancer patients seen per week, work setting, and financial status of patients. The smoking cessation model excluded work setting as a covariate.
↵†The treating depression, treating fatigue, and diet/physical activity models excluded work setting and financial status of patients as covariates.
↵‡The surveillance for recurrence model excluded gender as a covariate.
§Both the screening for new cancer and assessing genetic risk models excluded financial status of patients as a covariate.
||Both the late/long term treatment effects and pain models excluded gender, work setting, and financial status of patients as covariates.
¶The treating sexual side effects model excluded gender and financial status of patients as covariates.
Abbreviations: AOR, adjusted odds ratio; CI, confidence interval.
- Table 5.
Predictors of Confidence* in Providing Survivorship Care, 2019 Porter Novelli DocStyles Survey
Surveillance for recurrence Screening for new cancer Assessing Late/Long Term Treatment Effects Treating Pain Treating Fatigue Treating Sexual Dysfunction Treating Depression/anxiety Predictor± AOR, 95% CI AOR, 95% CI AOR, 95% CI AOR, 95% CI AOR, 95% CI AOR, 95% CI AOR, 95% CI Provider type Family Physician 0.87 (0.63, 1.18) 0.94 (0.66, 1.35) 0.77 (0.57, 1.05) 1.26 (0.92, 1.72) 1.27 (0.93, 1.73) 1.20 (0.89, 1.62) 1.55 (1.04, 2.32) Internist ref ref ref ref ref ref ref OBGYN 1.27 (0.86, 1.88) 0.73 (0.48, 1.10) 0.61 (0.43, 0.87) 0.23 (0.15, 0.34) 0.32 (0.22, 0.46) 3.52 (2.34, 5.30) 0.28 (0.19, 0.41) Nurse practitioner 0.65 (0.40, 1.05) 0.36 (0.22, 0.60) 0.59 (0.37, 0.96) 0.76 (0.47, 1.22) 1.13 (0.70, 1.82) 0.78 (0.49, 1.24) 0.58 (0.35, 0.97) Physician Assistant 1.02 (0.59, 1.76) 0.67 (0.37, 1.20) 0.61 (0.36, 1.04) 0.53 (0.31, 0.91) 0.81 (0.47, 1.38) 0.68 (0.40, 1.16) 0.54 (0.30, 0.96) Use of any guidelines Yes 2.11 (1.52, 2.92) 1.80 (1.27, 2.55) 1.65 (1.20, 2.27) 2.18 (1.57, 3.03) 2.14 (1.56, 2.95) 1.34 (0.98, 1.85) 1.64 (1.14, 2.36) No ref ref ref ref ref ref ref Survivorship care training Yes 1.92 (1.36, 2.73) 1.21 (0.83, 1.77) 2.32 (1.66, 3.26) 1.54 (1.10, 2.16) 1.76 (1.26, 2.45) 1.58 (1.14, 2.18) 1.29 (0.87, 1.91) No ref ref ref ref ref ref ref *Very confident/moderately confident versus somewhat/not at all confident.
↵±Models were adjusted for the following demographic and clinical characteristics: years in practice, provider type, gender, number of cancer patients seen per week, and work setting.
Abbreviations: AOR, adjusted odds ratio; CI, confidence interval.
