Predictors of Follow-Up Care Seeking Among Breast and Prostate Cancer Survivors

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DESCRIPTION (provided by applicant): Predictors of Follow-Up Care Seeking Among Breast and Prostate Cancer Survivors By 2050 the estimated number of cancer survivors will surpass new cancer cases, putting great demands on service providers and systems of care. More than half of individuals already diagnosed with cancer are expected to survive for more than 5 years. For breast and prostate cancers survival exceeds 88%. The American Society of Clinical Oncology projects a medical oncologist shortage by 2020 that will necessitate a multifaceted strategy to meet future cancer follow-up care demands. Therefore, primary care providers (PCPs) are increasingly being called upon to provide a "medical home" (i.e., usual source of care) for cancer survivors who have completed treatment. Currently one third of the 36.6 million physician office visits made for cancer care annually are made to PCPs. A study of SEER linked Medicare data reports that greater proportions of long-term breast and prostate cancer survivors (75% of those surviving 5+ yrs) receive care from primary care providers than cancer and cancer related specialists. Several studies suggest that survivors who see both oncologists and primary care physicians are more likely to receive recommended follow-up care than patients who see one or the other. Yet, there is little research that examines how patients think about their options for care, their decision making processes or the impact of these factors on receiving quality follow-up care. There is also limited research on cancer survivors who receive their treatment in community settings. While most adult cancer survivors in the US are treated for their cancers in community settings, much of the current survivorship research comes from patients treated at NCI designated comprehensive cancer centers. We address these important knowledge gaps in the proposed study. Specific aims of the study are to: (1) implement a survey study of adult cancer survivors treated in community settings that assesses and measures their primary care use and attitudes regarding their follow-up cancer care; (2) describe primary care usage of breast and prostate cancer survivors for follow-up care and recurrence surveillance; and, (3) assess cognitive- affective, patient support and demographic factors that affect how survivors use oncology specialists and PCPs for follow-up care. This descriptive, cross-sectional study of breast and prostate cancer survivors (n=400) will be conducted with patients treated at six community hospitals reflective of the diversity of community cancer treatment experiences in the state of NJ. Study results will provide a sound empirical basis for the development of interventions that enhance survivor care plans and optimize follow-up care in cancer survivor populations.