Abstract B012: “Just give it to us straight!”: A qualitative analysis of midwestern rural lung cancer survivors and caregivers about survivorship care experiences
Authors: Lewis-Thames Marquita W. , Gurolnik Anna E. , Grant Shakira J. , Keimweiss Sam 
Published: January 2023

Abstract
BACKGROUND: For over 40 years, rural lung cancer survivorship rates have lagged behind urban survivorship rates. Lower survivorship rates are partly related to decreased understanding of survivorship care needs and a reduced understanding of other elements common to survivorship care planning (e.g., review and management of treatment side-effects) by rural cancer survivors. However, the perspectives of rural lung cancer survivors regarding their experiences with survivorship care are unreported. We examined survivorship care experiences and barriers and facilitators to survivorship care navigation and implementation among rural lung cancer survivors and caregivers. METHODS: We conducted interviews from May 2021-June 2022. We purposively sampled rural patients with posttreatment lung cancer–within 5 years from their last active treatment–and caregivers of patients with lung cancer residing in Midwest communities. Participants self-identified as rural. Using a community-engaged recruitment strategy and snowballing technique, we recruited from rural and urban regional cancer centers, regional hospitals, and rural health clinics. Interviews were conducted either in person or by telephone. The interview guide questions probed participants regarding survivorship care implementation, knowledge, and navigation. All interviews were recorded and independently transcribed. Two analysts conducted a thematic analysis and inductively coded verbatim transcripts. RESULTS: Interviews were conducted with (n=22) lung cancer survivors and caregivers. Most participants were lung cancer survivors, Non-Hispanic White, at least 65 years old, married, female, have an annual household income of $75,000, received an Associate’s degree or less, and were previous smokers. There was an equal distribution of recent cancer diagnoses each year between 2018-2021. We coded similar perceptions between survivors and caregivers. Themes related to survivorship care included (1) Frustrations and anxiety were associated with unexpected barriers to adhering to care recommendations, (2) Participants emphasized needing clear posttreatment survivorship care recommendations, (3) Both self-reliance and strong supportive social networks were needed to cope with challenges associated with posttreatment care, and (4) Having patient-centered care and engaged caregivers helped survivors overcome barriers associated with survivorship care. Subthemes addressed multilevel (e.g., individual, community, policy) challenges and facilitators. CONCLUSION: Findings from this study illuminate the experiences of rural lung cancer survivors and caregivers’ survivorship care. Participants reported that survivorship care planning is frustrating and requires resilience and strong interpersonal relationships to navigate. Survivors and caregivers preferred clear, even candid, communication about their survivorship care planning and patient-centered care. Considering persistent rural-urban lung cancer survivorship disparities, tools to improve communication about survivorship care needs are needed.
Citation Format: Marquita W. Lewis-Thames, Anna E. Gurolnik, Shakira J. Grant, Sam Keimweiss. “Just give it to us straight!”: A qualitative analysis of midwestern rural lung cancer survivors and caregivers about survivorship care experiences [abstract]. In: Proceedings of the 15th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2022 Sep 16-19; Philadelphia, PA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2022;31(1 Suppl):Abstract nr B012.