Fowler Brynn, Ding Qian, Pappas Lisa, Wu Yelena P, Linder Lauri, Yancey Jeff, Wright Jennifer, Clayton Margaret, Kepka Deanna, Kirchhoff Anne C
Huntsman Cancer Institute, 2000 Circle of Hope Drive, Salt Lake City, UT, 84112, USA.
Study Design and Biostatistics Center, University of Utah, 295 Chipeta Way, Salt Lake City, UT, 84112, USA.
J Cancer Educ. 2018 Feb;33(1):214-221. doi: 10.1007/s13187-016-1098-y.
Assessments of cancer survivors' health-related needs are often limited to national estimates. State-specific information is vital to inform state comprehensive cancer control efforts developed to support patients and providers. We investigated demographics, health status/quality of life, health behaviors, and health care characteristics of long-term Utah cancer survivors compared to Utahans without a history of cancer. Utah Behavioral Risk Factor Surveillance System (BRFSS) 2009 and 2010 data were used. Individuals diagnosed with cancer within the past 5 years were excluded. Multivariable survey weighted logistic regressions and computed predictive marginals were used to estimate age-adjusted percentages and 95 % confidence intervals (CI). A total of 11,320 eligible individuals (727 cancer survivors, 10,593 controls) were included. Respondents were primarily non-Hispanic White (95.3 % of survivors, 84.1 % of controls). Survivors were older (85 % of survivors ≥40 years of age vs. 47 % of controls). Survivors reported the majority of their cancer survivorship care was managed by primary care physicians or non-cancer specialists (93.5 %, 95 % CI = 87.9-99.1). Furthermore, 71.1 % (95 % CI = 59.2-82.9) of survivors reported that they did not receive a cancer treatment summary. In multivariable estimates, fair/poor general health was more common among survivors compared to controls (17.8 %, 95 % CI = 12.5-23.1 vs. 14.2 %, 95 % CI = 12.4-16.0). Few survivors in Utah receive follow-up care from a cancer specialist. Provider educational efforts are needed to promote knowledge of cancer survivor issues. Efforts should be made to improve continuity in follow-up care that addresses the known issues of long-term survivors that preclude optimal quality of life, resulting in a patient-centered approach to survivorship.
对癌症幸存者健康相关需求的评估往往局限于全国性估计。特定州的信息对于为支持患者和医疗服务提供者而开展的州综合癌症控制工作至关重要。我们调查了犹他州长期癌症幸存者与无癌症病史的犹他州居民在人口统计学、健康状况/生活质量、健康行为和医疗保健特征方面的差异。使用了犹他州行为风险因素监测系统(BRFSS)2009年和2010年的数据。过去5年内被诊断患有癌症的个体被排除在外。采用多变量调查加权逻辑回归和计算预测边际来估计年龄调整后的百分比和95%置信区间(CI)。共纳入11320名符合条件的个体(727名癌症幸存者,10593名对照)。受访者主要为非西班牙裔白人(幸存者的95.3%,对照的84.1%)。幸存者年龄较大(85%的幸存者年龄≥40岁,而对照为47%)。幸存者报告称,他们的大多数癌症幸存者护理由初级保健医生或非癌症专科医生管理(93.5%,95%CI=87.9-99.1)。此外,71.1%(95%CI=59.2-82.9)的幸存者报告称他们没有收到癌症治疗总结。在多变量估计中,与对照相比,幸存者中一般健康状况为中等/较差的情况更为常见(17.8%,95%CI=12.5-23.1,而对照为14.2%,95%CI=12.4-16.0)。犹他州很少有癌症幸存者接受癌症专科医生的后续护理。需要开展医疗服务提供者教育工作,以提高对癌症幸存者问题的认识。应努力改善后续护理的连续性,解决长期幸存者已知的影响最佳生活质量的问题,从而形成以患者为中心的幸存者护理方法。