Abstract
Purpose
Though the need for risk-based follow-up care for survivors of adolescent and young adult (AYA) cancer has been documented, survivors often report forgoing recommended care due to cost. We sought to understand whether additional barriers to follow-up care exist for AYA survivors.
Methods
We recruited survivors who were diagnosed with cancer between the ages of 15 and 39 using the Utah Cancer Registry (UCR). Overall, 28 survivors participated in 6 focus groups held between March and May 2015 in Salt Lake City and St. George, UT. Focus group discussions focused on the reasons survivors may or may not attend recommended medical visits after completing therapy.
Results
Survivors reported myriad barriers to follow-up medical visits, including lack of clear provider recommendation, fear of recurrent cancer diagnosis, wishing to move on with life, competing life responsibilities due to work and children, and not perceiving the need for a visit due to lack of symptoms.
Conclusions
Though cost likely plays a major part in follow-up care adherence for survivors of AYA cancer, in our focus groups, participants indicated there were many other psychosocial and logistic barriers to care. Such factors play an important role in the day-to-day lives of survivors and are critical in medical decision-making.
Implications for cancer survivors
Several factors impede follow-up care adherence for survivors of AYA cancer that are amenable to interventions, including clearer provider recommendations, flexible appointment times, and childcare availability in clinics.
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Acknowledgments
We gratefully acknowledge funding from the Department of Pediatrics, University of Utah (K2R2R funding program) and the National Institutes of Health (K07CA196985 to YW). Additional support was provided by the Huntsman Cancer Foundation and the Huntsman Cancer Institute Cancer Center Support Grant No. P30 CA42014 from the National Cancer Institute. The content is solely the responsibility of the authors and does not necessarily represent the official views of the NIH.
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Smits-Seemann, R.R., Kaul, S., Zamora, E.R. et al. Barriers to follow-up care among survivors of adolescent and young adult cancer. J Cancer Surviv 11, 126–132 (2017). https://doi.org/10.1007/s11764-016-0570-3
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DOI: https://doi.org/10.1007/s11764-016-0570-3