International Survey of Psychosocial Care for Cancer Survivors in Low-/Middle- and High-Income Countries: Current Practices, Barriers, and Facilitators to Care
Authors: Signorelli Christina , Høeg Beverley Lim , Asuzu Chioma , Centeno Isabel , Estapé Tania , Fisher Peter , Lam Wendy , Levkovich Inbar , Manne Sharon , Miles Anne , Mullen Louise , Nekhlyudov Larissa , Sade Cristina , Shaw Joanne , Singleton Anna , Travado Luzia , Tsuchiya Miyako , Lemmen Jesse , Li Jie , Jefford Michael ,   On behalf of the International Psycho-Oncology Society Survivorship Special Interest Group, Altman Shiri , Anang Reginald , Asuzu Chioma , Barrera Maru , Basen-Engquist Karen , Bidstrup Pernille , Bilodeau Karine , Centeno Isabel , Christodoulidou Stephanie , Cirila Andreja , Cohee Andrea , Csaba Dégi László , Dhillon Haryana , Duijts Saskia , Estapé Tania , Fisher Peter , Foster Claire , Fournier Valentyn , Gitonga Isaiah , Goswami Savita , Ha Lauren , Hack Tom , Heathcote Lauren , Howard Fuchsia , Hulbert-Williams Nicholas , Jacobsen Paul , Jefford Michael , Kassianos Angelos , Koczwara Bogda , Lam Wendy , Lasebikan Victor , Lebel Sophie , Lemmen Jesse , Leslie Monica , Levkovich Inbar , Li Jie , Lim Høeg Beverley , Liu Xiaohong , Luigjes Yvonne , Manne Sharon , Martinez Tyson Dinorah , Mazariego Carolyn , Miles Anne , Mirov Yurii , Mullen Louise , Nandakumar Devi , Larissa Nekhlyudo Ray Nascimento , Odiyo Philip , Ortolan Paula , Reshetova Maria , Ruble Kathy , Sade Cristina , Shaw Joanne , Signorelli Christina , Singleton Anna , Smith Ben , Smrdel Škufca , Taylor Carolyn , Travado Luzia , Tsuchiya Miyako , Turner Jane , Veeraiah Surendran , Wells Elizabeth , Xu Lei , Zhang Anao 
Published: May 2024

PURPOSE The number of cancer survivors living with and beyond cancer treatment is rising globally. It is fundamental to understand the extent and type of psychosocial care services offered worldwide. We evaluated models of cancer survivorship care, psychosocial care practices in the post-treatment survivorship phase, and barriers/facilitators to delivery of psychosocial care services, including in low- and middle-income countries (LMICs). METHODS The International Psycho-Oncology Society (IPOS) Survivorship Special Interest Group led a cross-sectional online survey between March and November 2022. Health care professionals and researchers in psycho-oncology were invited through the IPOS global membership, social media, and snowballing. The survey was administered to individuals but included questions related to practices in their country at a national level. RESULTS Two hundred eighty-three respondents from 37 countries participated (40% from LMICs), with a median of 12 years of experience (IQR, 6-20) in the psycho-oncology field. Participants reported that the most common elements of routine survivorship care were related to the prevention/management of recurrences/new cancers (74%), physical late effects (59%), and chronic medical conditions (53%), whereas surveillance/management of psychosocial late effects (27%) and psychosocial/supportive care (25%) were least common. Service availability was more commonly reported in high-income countries (HICs) than LMICs related to reproductive health (29% v 17%), genetic counseling/support (40% v 20%), and identifying/managing distress (39% v 26%) and pain (66% v 48%). Key barriers included providers focusing on treatment not survivorship (57%), medical not psychosocial care (60%), and a lack of allied health providers to deliver psychosocial care (59%). CONCLUSION The psychosocial needs of people living with cancer are not adequately available and/or provided in post-treatment survivorship even in HICs, because of barriers at patient, provider, and system levels.