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  • 1
    Online Resource
    Online Resource
    American Society of Clinical Oncology (ASCO) ; 2012
    In:  Journal of Clinical Oncology Vol. 30, No. 15_suppl ( 2012-05-20), p. 6085-6085
    In: Journal of Clinical Oncology, American Society of Clinical Oncology (ASCO), Vol. 30, No. 15_suppl ( 2012-05-20), p. 6085-6085
    Abstract: 6085 Background: The longevity of CS is increasing, underscoring the importance of lifestyle modifications and preventive care, consisting of regular PA and maintenance of PF. Our aims were to 1) compare PA and PF among short-term CS, long-term CS and non-cancer controls (NCC) and 2) identify other clinical factors associated with decreased PA and PF. Methods: We identified CS and NCC from the US National Health and Nutrition Examination Survey (NHANES). CS were categorized into 〈 /=5 (short-term) and 〉 5 years (long-term) based on date of diagnosis. Multivariate weighted regression models were constructed to examine for differences in 28 and 26 measures of PA and PF, respectively, while controlling for age, gender, ethnicity, education, income, and other confounders. We explored specific and general PA domains such as aerobic activity and decline from past activity level as well as PF areas including ADLs, IADLs and mobility. Results: In total, 26,185 subjects were identified: 968 short-term CS, 1,367 long-term CS, and 23,832 NCC. For the entire cohort, the mean age was 50 years, 52% were men, and 50% were white. Comparing across the 3 patient groups, CS were generally older than NCC (60 vs 45 years, p 〈 0.01). In terms of PA, short-term CS reported less general activity compared to 1 year ago (OR 0.58, 95%, CI 0.46-0.73, p 〈 0.01) than long-term CS and NCC. In comparison to NCC, both groups of CS also described less current activity than their baseline from 10 years ago (OR 0.63, 95% CI 0.48-0.82, P=0.001 and OR 0.67, 95% CI 0.55-0.83, P= 〈 0.01). There were significant differences among patient groups in several areas of PF (Table). Other factors that were associated with lower PA and PF included advanced age, low education, and low income. Conclusions: PA between CS and NCC were similar, although current activity as compared to that of the preceding year or past decade appears lower in CS, which may reflect their older age. Impairments in several measures of PF were observed among CS, which could impact their quality and quantity of life. [Table: see text]
    Type of Medium: Online Resource
    ISSN: 0732-183X , 1527-7755
    RVK:
    RVK:
    Language: English
    Publisher: American Society of Clinical Oncology (ASCO)
    Publication Date: 2012
    detail.hit.zdb_id: 2005181-5
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  • 2
    Online Resource
    Online Resource
    American Society of Clinical Oncology (ASCO) ; 2014
    In:  Journal of Clinical Oncology Vol. 32, No. 15_suppl ( 2014-05-20), p. 6570-6570
    In: Journal of Clinical Oncology, American Society of Clinical Oncology (ASCO), Vol. 32, No. 15_suppl ( 2014-05-20), p. 6570-6570
    Type of Medium: Online Resource
    ISSN: 0732-183X , 1527-7755
    RVK:
    RVK:
    Language: English
    Publisher: American Society of Clinical Oncology (ASCO)
    Publication Date: 2014
    detail.hit.zdb_id: 2005181-5
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  • 3
    Online Resource
    Online Resource
    American Society of Clinical Oncology (ASCO) ; 2013
    In:  Journal of Clinical Oncology Vol. 31, No. 15_suppl ( 2013-05-20), p. 9598-9598
    In: Journal of Clinical Oncology, American Society of Clinical Oncology (ASCO), Vol. 31, No. 15_suppl ( 2013-05-20), p. 9598-9598
    Abstract: 9598 Background: The delivery of cancer survivorship care can be complicated by a lack of clarity surrounding physician roles during follow-up. This can be particularly challenging for young adult CS who face unique needs. Our aim was to characterize young CS’ follow-up care expectations of their PCPs and oncologists. Methods: A self-administered survey was mailed to all CS diagnosed with cancer from 2005 to 2009, aged 20 to 39 years at the time of diagnosis, evaluated at any 1 of 5 regional cancer centers in British Columbia, and lived beyond 2 years. The questionnaire focused on demographics, prior treatment, and CS attitudes regarding physician responsibilities during survivorship, specifically their views about their PCPs’ and oncologists’ roles. Descriptive statistics and regression analyses were used to summarize these expectations and to determine if they differed based on physician type. Results: A total of 426 patients were included (response rate 59%): current median age was 40 years (range 24-45) and 301 (71%) were women. Common tumor sites were breast (48%), testicular (27%), and gynecological (18%). Most patients (63 and 65%, respectively) expected PCPs to be responsible for following their most recent cancer and screening for future cancers. Nearly all (85 and 93%, respectively) indicated that PCPs should also provide preventive care and manage their co-morbidities. Conversely, a significant proportion (65%) felt that oncologists should remain responsible for addressing side effects of cancer treatments throughout survivorship. In terms of fertility discussions, half of patients viewed this as a role for oncologists whereas the remainder perceived this to be more suitable for PCPs. Interestingly, neither PCPs nor oncologists were seen to have any significant role in addressing social reintegration, interpersonal relationships, or sexual function, with 〈 30% of respondents expecting these to be discussed by either physician. Conclusions: Young adult CS expect PCPs to be responsible for most aspects of their ongoing care. More clarity regarding physician roles is required with respect to specific survivorship issues, such as fertility, sexual function and psychosocial health.
    Type of Medium: Online Resource
    ISSN: 0732-183X , 1527-7755
    RVK:
    RVK:
    Language: English
    Publisher: American Society of Clinical Oncology (ASCO)
    Publication Date: 2013
    detail.hit.zdb_id: 2005181-5
    Location Call Number Limitation Availability
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  • 4
    Online Resource
    Online Resource
    American Society of Clinical Oncology (ASCO) ; 2014
    In:  Journal of Clinical Oncology Vol. 32, No. 15_suppl ( 2014-05-20), p. 6567-6567
    In: Journal of Clinical Oncology, American Society of Clinical Oncology (ASCO), Vol. 32, No. 15_suppl ( 2014-05-20), p. 6567-6567
    Type of Medium: Online Resource
    ISSN: 0732-183X , 1527-7755
    RVK:
    RVK:
    Language: English
    Publisher: American Society of Clinical Oncology (ASCO)
    Publication Date: 2014
    detail.hit.zdb_id: 2005181-5
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  • 5
    Online Resource
    Online Resource
    American Society of Clinical Oncology (ASCO) ; 2013
    In:  Journal of Clinical Oncology Vol. 31, No. 15_suppl ( 2013-05-20), p. e14603-e14603
    In: Journal of Clinical Oncology, American Society of Clinical Oncology (ASCO), Vol. 31, No. 15_suppl ( 2013-05-20), p. e14603-e14603
    Abstract: e14603 Background: While urban-rural differences in cancer care are well described, the etiology of these disparities is unclear. Our aims were to 1) characterize differences in AC use based on community size and 2) determine if such disparities are mediated through variations in driving distance (DD) and travel time (TT) to closest cancer center. Methods: Patients diagnosed with stage 2 and 3 RC from 1999 to 2009 and referred to any 1 of 5 regional cancer centers in British Columbia were reviewed. Communities were classified as rural, small urban, moderate urban and large urban based on census data. Using zip codes and a distance matrix application interface, DD and TT to the closest cancer center were determined and categorized into quartiles. Stepwise logistic regression models were constructed to explore AC use based on urban vs rural communities, adjusting for DD and TT. Results: A total of 3,017 patients were identified: median age was 67 years (IQR 58-75), 64% were men and 58% received AC. Patients were distributed across various communities: rural 36%; small urban 12%; moderate urban 13%; and large urban 39%. There were no differences in baseline patient and disease characteristics based on community size (all p 〉 0.05). Compared to patients in large urban centers, those living in rural, small urban and moderate urban areas were less likely to be treated with AC (62 vs 49 vs 54 vs 58%, respectively, p 〈 0.001). Likewise, DD and TT were shortest for large urban and longest for rural residents (both p 〈 0.001). In multivariate analyses that controlled for confounders, urban-rural disparities in receipt of AC persisted, but these differences significantly diminished after adjusting for DD, TT, or both (Table). Conclusions: Urban-rural disparities in AC use is partly mediated by commute. Strategic distribution of cancer services that reduce DD and TT to cancer centers may improve access to AC for a number of RC patients who are living in smaller communities. [Table: see text]
    Type of Medium: Online Resource
    ISSN: 0732-183X , 1527-7755
    RVK:
    RVK:
    Language: English
    Publisher: American Society of Clinical Oncology (ASCO)
    Publication Date: 2013
    detail.hit.zdb_id: 2005181-5
    Location Call Number Limitation Availability
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  • 6
    Online Resource
    Online Resource
    American Society of Clinical Oncology (ASCO) ; 2013
    In:  Journal of Clinical Oncology Vol. 31, No. 15_suppl ( 2013-05-20), p. 9593-9593
    In: Journal of Clinical Oncology, American Society of Clinical Oncology (ASCO), Vol. 31, No. 15_suppl ( 2013-05-20), p. 9593-9593
    Abstract: 9593 Background: Survivorship care plans have strong face validity, but individualizing plans to each patient’s needs can be resource intensive. At our institution, a 1-page standardized letter that outlines the essential components of follow-up care is mailed to PCPs at the time of a patient’s discharge. This letter highlights the recommended frequency and interval of tests and physician visits. Our study aims were to 1) characterize PCPs’ attitudes regarding these letters and 2) identify potential strategies to improve this channel of communication with PCPs. Methods: Self-administered surveys were mailed to high-volume PCPs in British Columbia, defined as those whose practices followed 〉 /=5 breast or colorectal CS in the preceding year. The survey asked about practice characteristics and PCPs’ views towards the content and format of these standardized letters. Logistic regression models were constructed to delineate factors associated with follow-up preferences. Results: Among 787 PCPs, 507 (64%) responded: median year since graduation was 27 (range 1-62), 67% were men, 38% had a faculty appointment, 71% practiced in a group, and 92% were paid fee-for-service. When asked about their perspectives regarding the care of CS, 388 (77%) indicated they were comfortable providing follow-up with 299 (74%) reporting that the standardized letter contained adequate information. In regression models, PCPs who were comfortable with cancer surveillance and those who graduated greater than 30 years ago were more likely to view the standardized letter as useful (OR 2.50, 95% CI 1.41-4.43 and OR 2.31, 95% CI 1.24-4.33, respectively) and important (OR 4.07, 95% CI 1.80-9.19 and OR 3.14, 95% CI 1.01-9.74, respectively). Among 103 (26%) PCPs who found the letter to be insufficient, most wanted additional details about the cancer diagnosis (88%), specific information on the toxicities of therapy (88%), and the estimated risk of recurrence (84%). Conclusions: Most PCPS were satisfied with a simple, standardized letter that outlines the necessary components of cancer follow-up. PCPs with less familiarity with cancer surveillance may be a target group that benefits most from individualized survivorship care plans.
    Type of Medium: Online Resource
    ISSN: 0732-183X , 1527-7755
    RVK:
    RVK:
    Language: English
    Publisher: American Society of Clinical Oncology (ASCO)
    Publication Date: 2013
    detail.hit.zdb_id: 2005181-5
    Location Call Number Limitation Availability
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