Abstract D079: Oncologists’ approach in managing pre-existing chronic comorbidities during patients’ active cancer treatment
Authors: Pierre-Victor Dudith , Martin Iman K. , Adjei Brenda , Shaw-Ridley Mary , Rapkin Bruce , Good Marjorie , Germain Diane ST. , Parker Bernard , McCaskill-Stevens Worta 
Published: September 2020

Abstract
Background Cancer frequently occurs with other chronic diseases, and this poses serious care coordination challenges during patients’ active cancer treatment (ACT) and contributes to disparities in health outcomes. There is limited research addressing pre-existing chronic comorbidity (PCC) management during ACT. This study aimed to examine oncologists’ approach for PCC management during ACT. Methods Oncologists in the National Cancer Institute’s Community Oncology Research Program (NCORP) were surveyed about their approach in managing PCC. The Likert scale survey was piloted-tested, IRB-approved, and administered to oncologists. In December 2018, NCORP network oncologists were sent an email invitation to complete the online survey. Pearson chi-square test was used to identify differences in oncologists’ management approach of PCC. Results Among the 375 respondents of the ongoing survey, 45.6% practiced primarily as medical oncologists, 37.3% as hematology, surgical, or radiation oncologists, and 17.1% as other oncology specialists. Approximately 70% of oncologists reported that &gt;50% of their patients had ≥ 1 PCC. When asked about the three most challenging PCC to manage, 23.3% cited diabetes, 19.5% cited heart disease, and 57.1% cited another PCC. Medical oncologists were more likely to cite diabetes first (77.5%) and less likely (22.5%) to cite heart disease first compared to other specialists (p=0.004). Co-management with patients’ PCP was the most common management approach for diabetes among medical oncologists (42.2%) compared to those of other specialties (15.0%) while referral to other physicians was the most common approach among those of other specialties (50.0%) compared to medical oncologists (22.5%) (p=0.002). Consultation and referral were the most common management approaches for heart disease across oncology specialties. Conclusion Oncologists face significant challenges to manage patients’ PCC during ACT. These results indicate that the medical oncologist is more likely to co-manage diabetes with patients’ PCP compared to other oncology specialists, but heart disease was seldom co-managed. Greater collaboration between oncology and non-oncology specialists is needed for effective management of PCC during ACT to ensure complete and coordinated care and to reduce disparities in health outcomes for these patients.
Citation Format: Dudith Pierre-Victor, Iman K. Martin, Brenda Adjei, Mary Shaw-Ridley, Bruce Rapkin, Marjorie Good, Diane ST. Germain, Bernard Parker, Worta McCaskill-Stevens. Oncologists’ approach in managing pre-existing chronic comorbidities during patients’ active cancer treatment [abstract]. In: Proceedings of the Twelfth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2019 Sep 20-23; San Francisco, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(6 Suppl_2):Abstract nr D079.