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

描述（由申请人提供）：乳腺癌和前列腺癌幸存者寻求后续护理的预测因素到2050年，癌症幸存者的估计数量将超过新的癌症病例，对服务提供者和护理系统提出了很大的要求。超过一半的已诊断为癌症的人预计将存活5年以上。乳腺癌和前列腺癌的存活率超过88%。美国临床肿瘤学会（American Society of Clinical Oncology）预测，到2020年，医学肿瘤学家将短缺，这将需要多方面的战略来满足未来的癌症随访护理需求。因此，越来越多地要求初级保健提供者（PCP）提供“医疗之家”（即，通常的护理来源）为已完成治疗的癌症幸存者。目前，每年为癌症护理进行的3660万次医生办公室访问中有三分之一是向PCP进行的。一项与SEER相关的医疗保险数据研究报告称，与癌症和癌症相关专家相比，乳腺癌和前列腺癌长期幸存者（生存5年以上的患者中有75%）接受初级保健提供者的护理。几项研究表明，既看肿瘤学家又看初级保健医生的幸存者比看一个或另一个的患者更有可能接受推荐的后续护理。然而，很少有研究探讨患者如何看待他们的护理选择，他们的决策过程或这些因素对接受优质后续护理的影响。对在社区环境中接受治疗的癌症幸存者的研究也很有限。虽然美国大多数成年癌症幸存者在社区环境中接受癌症治疗，但目前的大部分生存研究来自NCI指定的综合癌症中心治疗的患者。我们在拟议的研究中解决这些重要的知识差距。研究的具体目标是：（1）对在社区环境中接受治疗的成年癌症幸存者进行调查研究，评估和衡量他们对初级保健的使用情况和对后续癌症护理的态度;（2）描述乳腺癌和前列腺癌幸存者对初级保健的使用情况，以进行后续护理和复发监测;以及（3）评估影响幸存者如何使用肿瘤专家和PCP进行后续护理的认知情感、患者支持和人口统计学因素。乳腺癌和前列腺癌幸存者（n=400）的描述性横断面研究将在6家社区医院接受治疗的患者中进行，反映了新泽西州社区癌症治疗经验的多样性。研究结果将为制定干预措施提供可靠的经验基础，以加强幸存者护理计划并优化癌症幸存者人群的后续护理。

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.