International Survey of Psychosocial Care for Cancer Survivors in Low-/Middle- and High-Income Countries: Current Practices, Barriers, and Facilitators to Care
Christina Signorelli, Beverley Lim Høeg, Chioma Asuzu, Isabel Centeno, Tania Estapé, Peter Fisher, Wwt Lam, Inbar Levkovich, Sharon L. Manne, Anne Miles, Louise Mullen, Larissa Nekhlyudov, Cristina Sade, Joanne Shaw, Anna Singleton, Luzia Travado, Miyako Tsuchiya, Jesse Lemmen, Jie Li, Michael Jefford, On behalf of the International Psycho-Oncology Society Survivorship Special Interest Group, Shiri Altman, Reginald Anang, Chioma Asuzu, Maru Barrera, Karen Basen‐Engquist, Pernille Envold Bidstrup, Karine Bilodeau, Isabel Centeno, Stephanie Christodoulidou, Andreja Cirila, Andrea A. Cohee, László Csaba Dégi, Haryana M. Dhillon, Saskia F. A. Duijts, Tania Estapé, Peter Fisher, Claire Foster, Valentyn Fournier, Isaiah Gitonga, Savita Goswami, Lauren Ha, Tom Hack, Lauren C. Heathcote, A. Fuchsia Howard, Nick Hulbert-Williams, Paul B. Jacobsen, Michael Jefford, Angelos P. Kassianos, Bogda Koczwara, Wendy Lam, Victor Olufolahan Lasebikan, Sophie Lebel, Jesse Lemmen, Monica Leslie, Inbar Levkovich, Jie Li, Beverley Lim Høeg, Xiaohong Liu, Yvonne Luigjes, Sharon L. Manne, Dinorah Martinez Tyson, Carolyn Mazariego, Anne Miles, Yurii Mirov, Louise Mullen, Devi Nandakumar, Ray Nascimento Larissa Nekhlyudo, Philip Odiyo, Paula Elias Ortolan, Maria Reshetova, Kathy Ruble, Cristina Sade, Joanne Shaw, Christina Signorelli, Anna Singleton, Ben Smith, Škufca Smrdel, Carolyn Taylor, Luzia Travado, Miyako Tsuchiya, Jane Turner, Surendran Veeraiah, Elizabeth Wells, Lei Xu, Anao Zhang
Abstract
PURPOSE The number of cancer survivors living with and beyond cancer treatment is rising globally. It is fundamental to understand the extent and type of psychosocial care services offered worldwide. We evaluated models of cancer survivorship care, psychosocial care practices in the post-treatment survivorship phase, and barriers/facilitators to delivery of psychosocial care services, including in low- and middle-income countries (LMICs). METHODS The International Psycho-Oncology Society (IPOS) Survivorship Special Interest Group led a cross-sectional online survey between March and November 2022. Health care professionals and researchers in psycho-oncology were invited through the IPOS global membership, social media, and snowballing. The survey was administered to individuals but included questions related to practices in their country at a national level. RESULTS Two hundred eighty-three respondents from 37 countries participated (40% from LMICs), with a median of 12 years of experience (IQR, 6-20) in the psycho-oncology field. Participants reported that the most common elements of routine survivorship care were related to the prevention/management of recurrences/new cancers (74%), physical late effects (59%), and chronic medical conditions (53%), whereas surveillance/management of psychosocial late effects (27%) and psychosocial/supportive care (25%) were least common. Service availability was more commonly reported in high-income countries (HICs) than LMICs related to reproductive health (29% v 17%), genetic counseling/support (40% v 20%), and identifying/managing distress (39% v 26%) and pain (66% v 48%). Key barriers included providers focusing on treatment not survivorship (57%), medical not psychosocial care (60%), and a lack of allied health providers to deliver psychosocial care (59%). CONCLUSION The psychosocial needs of people living with cancer are not adequately available and/or provided in post-treatment survivorship even in HICs, because of barriers at patient, provider, and system levels.