Key points are not available for this paper at this time.
Importance Since 2021, American College of Surgeons Commission on Cancer (CoC) accreditation standards require providing a survivorship program for patients with adult-onset cancer treated with curative intent. Since more than 70% of all patients with cancer in the US are treated at CoC-accredited facilities, this presents an opportunity for a landscape analysis of survivorship care availability. Objective To determine the prevalence, types, and outcomes of cancer survivorship services at CoC-accredited facilities. Design, Setting, and Participants This survey study used an anonymous, online, cross-sectional survey conducted from May 4 to 25, 2023. Participants were CoC-accredited facilities in the US representing diverse CoC program categories, institutional characteristics, geographic regions, and practice types. Department of Veterans Affairs cancer programs were excluded due to data usage restrictions. Data were analyzed from July to October 2023. Exposure CoC Survivorship Standard 4.8 was released in October 2019 and programs were expected to adhere to the Standard beginning January 1, 2021. Main Outcomes and Measures Questions included self-reported survivorship program characteristics, availability of services aligned to CoC Survivorship Standard 4.8, and perceived program impacts. Response frequencies and proportions were determined in aggregate and by CoC program category. Results There were 1400 eligible programs, and 384 programs participated (27.4% response rate). All regions and eligible program categories were represented, and most had analytic caseloads of 500 to 4999 patients in 2021. Most survivorship program personnel included nurses (334 programs 87.0%) and social workers (278 programs 72.4%), while physical (180 programs 46.9%) and occupational (87 programs 22.7%) therapists were less common. Services most endorsed as available for all survivors were screening for new cancers (330 programs 87.5%), nutritional counseling (325 programs 85.3%), and referrals to specialists (320 programs 84.7%), while treatment summaries (242 programs 64.7%), and survivorship care plans (173 programs 43.0%), sexual health (217 programs 57.3%), and fertility (214 programs 56.9%) were less common. Survivorship services were usually delivered by cancer treatment teams (243 programs 63.3%) rather than specialized survivorship clinics (120 programs 31.3%). For resources needed, additional advanced practice clinicians with dedicated survivorship effort (205 programs 53.4%) and electronic health record enhancements (185 programs 48.2%) were most endorsed. Lack of referrals and low patient awareness were endorsed as the primary barriers. A total of 335 programs (87.2%) agreed that Survivorship Standard 4.8 helped advance their programs. Conclusions and Relevance These findings of this survey study of CoC-accredited programs establish a benchmark for survivorship care delivery in the US, identify gaps in specific services and opportunities for intervention, contribute to longitudinal reevaluation for tracking progress nationally, and suggest the value of survivorship care standards.
Stal et al. (Wed,) studied this question.