ORIGINAL RESEARCH
Julie S. Townsend, MS; Elizabeth A. Rohan, PhD, MSW; Susan A. Sabatino, MD, MPH; Mary Puckett, PhD
Corresponding Author: Julie S. Townsend, MS; Division of Cancer Prevention and Control, Centers for Disease Control and Prevention
Email: jtownsend@cdc.gov
DOI: 10.3122/jabfm.2023.230036R1
Keywords: Cancer, Cancer Survivors, Clinical Guidelines, Disease Management, Logistic Regression, Primary Health Care, Survivorship
Dates: Submitted: 01-30-2023; Revised: 04-21-2023; Accepted: 05-01-2023
Status: In production for ahead of print.
BACKGROUND: National organizations have issued comprehensive cancer survivorship care guidelines to improve care of cancer survivors, many of whom receive care from primary care providers (PCPs).
METHODS: We analyzed Porter Novelli’s 2019 fall DocStyles survey to assess use of cancer survivorship care guidelines, receipt of survivorship training, types of survivorship services provided, and confidence providing care among PCPs in the United States. We grouped PCPs by use of any guideline (“users”) vs. no guideline use (“non-users”). We calculated descriptive statistics and conducted multivariable logistic regression analyses to examine guideline use, having received training on providing survivorship care services, and confidence in providing care. Within the panel, sampling quotas were set so that 1,000 primary care physicians, 250 OB/GYNs, 250 pediatricians, and 250 nurse practitioners/physician assistants were recruited.
RESULTS: To reach selected quotas, 2,696 health professionals were initially contacted to participate, resulting in a response rate of 64.9%. Sixty-two percent of PCPs reported using guidelines and 17% reported receiving survivorship care training. Use of any guidelines or receiving training was associated with reporting providing a range of survivorship services and confidence in providing care. After adjusting for demographic characteristics, guideline users were more likely than non-users to report assessing genetic cancer risk (OR=2.65 95% confidence interval (CI) (1.68, 4.17)), screening for cancer recurrence (OR=2.32 95% CI (1.70, 3.18)) or a new cancer (OR=1.63, 95% CI (1.20, 2.22)), and treating depression (OR=1.64, 95% CI (1.20, 2.25)). Receipt of training was also positively associated with providing genetic risk assessment, surveillance for recurrence, as well as assessing late/long-term effects, and treating pain, fatigue, and sexual side effects.
CONCLUSION: Survivorship care guidelines and training support PCPs in providing a range of survivorship care services.