Disparities Exist in Use of Survivorship Plans

Despite recommendations for use of comprehensive survivorship care plans (SCPs), certain patients with cancer are less likely to receive them, including those with lower education and those who are uninsured.

A new study analyzed 7,061 eligible adult cancer survivors from the 2016 Behavior Risk Factor Surveillance System’s Survivorship modules. About 30% of this sample did not receive follow-up instructions and 55% did not receive treatment summaries.

Thirty-nine percent of survivors reported receipt of an SCP. The probability of receiving an SCP decreased with lower education. About 43% of survivors with at least a college degree reported receipt of an SCP compared with 37.5% of survivors with high school or some college education and 32.4% of those with less than a high school education. Compared with survivors with at least one college degree, those with a high school education/some college education had an adjusted odds ratio [AOR] for receipt of a SCP of 0.82 (P=0.02); those with less than a high school education had an AOR of 0.68 (P=0.03).

“The disparities in the receipt of SCPs based upon cancer survivor’s educational status highlight the importance of delivery of comprehensive SCP with equitable coverage in the delivery,” the researchers wrote.

The researchers also found that marital status affected likelihood of receipt of an SCP. Specifically, being widowed/divorced/separated was associated with lower likelihood (AOR=0.72; P<0.01) compared with being married. Compared with insured survivors, those without insurance had an AOR of 0.52 for receipt of an SCP (P<0.01). Finally, younger patients were more likely to receive an SCP compared with those older than 65 (AOR=6.62; P<0.01).

“Multi-sectoral health policy initiatives, addressing both patient education and access, may be necessary to increase the delivery of SCPs among cancer survivors,” the researchers concluded.