Cancer survivors may have unique medical care needs due to chronic/late-occurring effects of cancer or cancer treatment. “Shared care,” which involves delivery of components of survivorship care by both oncologists and primary care providers (PCPs), may lead to increased coordination of care and may better address survivors' needs. However, little is known regarding potential disparities in receipt of shared care among cancer survivors. We examined associations between cancer survivors' sociodemographic characteristics and their receipt of shared care. SEER-CAHPS data, linking NCI's Surveillance, Epidemiology, and End Results (SEER) registry data, Medicare claims, and Medicare Consumer Assessment of Healthcare Providers and Systems (CAHPS) survey responses, were used. Individuals age >65 years at diagnosis in 2000-2011 SEER-CAHPS with breast, cervical, colorectal, lung, renal, or prostate cancers or hematologic malignancies who responded to a Medicare CAHPS survey >18 months after diagnosis were included. Individuals were classified in four mutually exclusive survivorship care patterns: Shared Care, Oncologist-led, PCP-led, or Other survivorship care, based on the proportions of their oncologist, PCP, and other physician encounters in Medicare claims data. Differences in survivorship care pattern by sex, age, education, race/ethnicity, and dual Medicare-Medicaid status were examined. Among the 10,132 survivors included in the study, 15.1%, 10.0%, 32.7%, and 42.2% received Shared Care, Oncologist-led, PCP-led, and Other care patterns, respectively. Compared with survivors in Shared Care, significantly greater proportions of those in the PCP-led pattern were over age 85 (24% PCP-led vs. 16% Shared Care), female (55% PCP-led vs. 44% Shared Care), and had high school or less educational attainment (52% PCP-led vs. 46% Shared Care). A significantly smaller proportion of survivors in the Oncologist-led pattern were older than age 85 (12% Oncologist-led vs. 16% Shared Care). Significantly more of those in the Other survivorship care pattern compared with Shared Care were older than age 85 (21% Other vs. 16% Shared Care) and non-Hispanic White (87% Other vs. 81% Shared Care), and fewer survivors in the Other care pattern had high school or less educational attainment (42% Other vs. 46% Shared Care). Overall, we found few significant and consistent associations between sociodemographic characteristics and receipt of Shared Care among cancer survivors in the SEER-CAHPS data set. However, these characteristics may influence type of survivorship care pattern received. Further research is needed to examine the role of patient characteristics in receiving different survivorship care patterns.
Citation Format: Michael T. Halpern, Julia Cohen, Lisa M. Lines, Michelle A. Mollica, Erin E. Kent. Association of cancer survivors' sociodemographic characteristics with survivorship care patterns [abstract]. In: Proceedings of the Eleventh AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2018 Nov 2-5; New Orleans, LA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(6 Suppl):Abstract nr B010.