Abstract PD4-05: Survivorship care planning is associated with breast cancer survivors' reported quality and coordination of care
Authors: McDowell BD , Klemp J , Blaes A , Cohee AA , Trentham-Dietz A , Kamaraju S , Otte JL , Rock JL , Rubenstein L , Chrischilles EA 
Published: March 2017

Primary goals of cancer survivorship care planning (SCP) include the assessment of ongoing risks for late effects and the coordination of health care. SCP strives to improve communication and coordination between survivors, health-care, and supportive care providers. Results on the effectiveness of SCP have been mixed. We report on the relationship between self-reported indicators of care with two essential elements of SCP: receipt of a written treatment summary and written instructions for routine cancer check-ups.

Methods: The Greater Plains Collaborative Clinical Data Research Network conducted the Share Thoughts on Breast Cancer survey across 8 cancer-care delivery sites across the Midwest. Participants were women age 18 years and older who had completed treatment for noninvasive or invasive (but not metastatic) breast cancer diagnosed from 1/1/2013 to 5/1/2014. Women were excluded if diagnosed with lobular carcinoma in situ, had previously been diagnosed with cancer per tumor registry records, did not report having cancer-directed surgery, or did not respond to questions about survivorship care planning. Logistic regression was used to examine characteristics and outcomes associated with a three-category SCP summary variable: (a) received both a written treatment summary and instructions for follow-up care; (b) received only one of these elements; or (c) received neither element. Adjustment variables included age at diagnosis, race, marital status at diagnosis, education, history of smoking, number of comorbidities, self-report that one health professional coordinated cancer care, type of surgery, and treatment with chemotherapy, radiation or hormones, and practice site.

Results: Of the 1148 survivors meeting study criteria, 485 (42.2%), 420 (36.6%), and 243 (21.2%) reporting receiving both SCP elements, one element, or no element, respectively. Several factors were associated with receiving elements of SCP: Those who reported having a single health professional who coordinated their cancer care were twice as likely to receive both elements of the SCP vs neither element (OR=2.3; 95% CI 1.6-3.2). Of patients who received both SCP elements, 88% reported excellent/very good quality of care compared to 73% who received neither element (p = .001). Respondents who reported always knowing who to ask questions about their cancer were far more likely to have received both elements vs neither element (OR=10.1; 95% CI 5.2-19.4). No association was observed between SCP and cancer care delivery site.

Conclusions: Breast cancer survivors who reported receiving a written summary of treatment and instructions for follow-up care reported better quality of cancer care, and they were also more confident about how to find answers to cancer related questions. Survivors who receive SCP were also more likely to have a single health professional coordinating their cancer care, potentially illustrating how SCP may fit into overall care processes.

Citation Format: McDowell BD, Klemp J, Blaes A, Cohee AA, Trentham-Dietz A, Kamaraju S, Otte JL, Rock JL, Rubenstein L, Chrischilles EA. Survivorship care planning is associated with breast cancer survivors' reported quality and coordination of care [abstract]. In: Proceedings of the 2016 San Antonio Breast Cancer Symposium; 2016 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2017;77(4 Suppl):Abstract nr PD4-05.