Abstract PS9-03: Reported concerns and acceptance of information or referrals among survivors with breast cancer seen for survivorship care planning visits: Results from the University of Wisconsin Carbone Cancer Center (UWCCC) Survivorship Program
Authors: Cha Leah , Tevaarwerk Amye J , Smith Elena M , Chandereng Thevaa , Huenerberg Karol J , Seaborne Lori A , Sesto Mary E 
Published: February 2021

Background: Survivors diagnosed with breast cancer experience a wide range of physical, psychosocial, and socioeconomic challenges following curative-intent treatment. Given survivors’ unique and complex needs, a coordinated transition from active treatment to post-treatment care is crucial and is often facilitated by survivorship care planning visits. Care planning visits are expected to identify survivors’ specific needs and provide information or referrals for additional services. However, little is known about survivors’ need for and acceptance of information or referrals at the end of curative-intent treatment, particularly in the context of care planning visits. To understand how we can improve delivery of post-treatment care for curatively treated survivors, we examined the frequency and patterns of concerns reported by survivors seen for care planning visits, as well as their acceptance of information and/or referrals.

Methods: Survivors diagnosed with Stage 0-3 breast cancer seen at the UWCCC for survivorship care planning visits at roughly one month after radiation therapy were identified using the electronic health record (EHR). An EHR data pull of a cohort seen between January 2016 to January 2020 was performed to extract discrete data on survivor demographics, clinical characteristics, concerns, and acceptance of information or referrals at the time of the initial survivorship care planning visit.

Results: A total of 1,016 survivors with breast cancer were seen for at least one care planning visit following radiation therapy as standard of care. Most survivors were middle-aged (mean = 58; range = 22-88), female (n = 1,014; 99.8%), and White (n = 962; 94.7%). Most survivors had private health insurance (n = 626; 61.6%) and received endocrine therapy (n = 718; 70.7%). About one-third of survivors received chemotherapy (n = 354; 34.8%). Nearly all survivors reported at least one concern (n = 975; 96.0%). Activity-related concerns, such as fatigue and desire to increase physical activity, were most commonly reported among survivors (n = 739; 72.7%), followed by concerns related to nutrition (n = 677; 66.6%) and pain or swelling (n = 630; 62.0%). Among survivors who reported a concern, most accepted information about activity or pain (n = 842; 98.6%). Acceptance of referrals to services were generally fewer in number than of information, with the most accepted referrals being for nutrition (n = 46; 6.8%). More than ninety percent of survivors who reported a concern related to activity or pain (n = 842; 98.6%), nutrition (n = 669; 98.8%), and substance use (n = 50; 92.6%) accepted information or referrals for services. Most survivors who reported a concern related to endocrine therapy (n = 221; 95.7%) and employment or insurance (n = 118; 88.7%), however, did not seek additional support.

Conclusions: Our analysis of discretely collected EHR data of survivors with breast cancer suggests that although survivors seen for care planning visits report a range of concerns at the end of active curative-intent treatment, they may not necessarily accept information or referrals for services to address some of their concerns. A possible reason for this occurrence may be that these routinely seen survivors have already received resources to address their concerns at visits prior to the care planning visits. Survivors may have also declined resources due to barriers to health care access, such as those related to finances, transportation, and child care. Further studies are needed to understand this discrepancy and determine how to effectively meet both the desires and needs of this population.

Citation Format: Leah Cha, Amye J Tevaarwerk, Elena M Smith, Thevaa Chandereng, Karol J Huenerberg, Lori A Seaborne, Mary E Sesto. Reported concerns and acceptance of information or referrals among survivors with breast cancer seen for survivorship care planning visits: Results from the University of Wisconsin Carbone Cancer Center (UWCCC) Survivorship Program [abstract]. In: Proceedings of the 2020 San Antonio Breast Cancer Virtual Symposium; 2020 Dec 8-11; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2021;81(4 Suppl):Abstract nr PS9-03.