Survey responses from adult cancer survivors suggest that an increasing high level of unmet needs exists among this population and underscore the need for improved survivorship care models that involve integrated care and a smoother transition from cancer therapy (JAMA Netw Open. 2020;3[3]:e200506).

“Understanding the challenges faced by an increasing number of cancer survivors can guide the development and implementation of effective survivorship care models,” explained Saad Shakeel, MPH, School of Medicine, University of Toronto, Ontario, Canada, and co-investigators.

Thus, Dr Shakeel et al conducted a cross-sectional survey with cancer agencies across Canada to identify the physical, emotional, and practical concerns and related unmet needs of cancer survivors.

Using data from the Experiences of Cancer Patients in Transitions Study of the Canadian Partnership Against Cancer, the investigators surveyed cancer survivors aged ≥30 years who underwent chemotherapy, radiotherapy, surgery, or a combination of these therapies for breast, prostate, colorectal, melanoma, or blood cancer in the previous 1 to 3 years.

The main goals of the survey were to quantify the magnitude and variety of physical, emotional, and practical concerns of adult cancer survivors; explore the extent of associated unmet needs; and identify patient-, treatment-, and cancer-specific factors tied to the reporting of unmet needs.

Ultimately, 10,717 adults responded to the survey in 2016, including 6367 (60%) aged ≥65 years. Dr Shakeel and colleagues carried out data synthesis and quality assessment in 2017, and completed data analysis in July 2019.

Each respondent had a median of 6 concerns; those with concerns sought help for a median of 2 concerns, and unmet needs were documented for a median of 4 concerns.

Overall, emotional, physical, and practical concerns were reported by 8330 (78%), 9236 (86%), and 4668 (44%) respondents, and at least 1 unmet need was reported by 7033 (84%), 7475 (81%), and 3459 (74%) survivors with these concerns, respectively.

Factors significantly tied to unmet needs were age, sex, annual income, marital status, geographic location, language, and treatment type. Notably, cancer survivors who had melanoma were significantly more likely to report unmet emotional needs (odds ratio [OR], 1.75; 95% CI, 1.17-2.61; P = .01) than survivors of prostate (OR, 0.60; 95% CI, 0.43-0.84; P <.001) and hematologic (OR, 0.70; 95% CI, 0.50-0.99; P = .04) cancers, who were also significantly less likely to report unmet needs for physical concerns than breast cancer survivors.

Combined provision of care from the general practitioner and oncologist was tied to a significantly lower probability of reporting unmet emotional (OR, 0.78; 95% CI, 0.62-1.00; P = .05) or practical (OR, 0.72; 95% CI, 0.55-0.94; P = .01) needs.

“The extent of unmet needs among cancer survivors found in this study suggests the need for enhancements in survivorship care, including better awareness of the realities of survivorship, earlier interventions for emerging concerns among survivors, and greater integration of cancer programs and primary care for more seamless transitions,” Dr Shakeel and colleagues concluded.—Hina Porcelli