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Survivorship care in Canadian genitourinary oncology: Toward a multidisciplinary perspective.

337 Background: Genitourinary (GU) cancer survivors comprise nearly 25% of cancer survivors and >50% of all male survivors. To further improve care of this patient population, we need to better understand physician specialist perceptions of survivorship care.


METHODS
All medical oncologists, urologists and radiation oncologists treating GU cancers in Canada were surveyed with a web-based questionnaire. A total of 27 multiple choice and Likert scale questions were developed in 5 domains: i) demographics, ii) current post cancer treatment care practices, iii) perceived barriers, iv) accessibility to survivorship resources and v) perceptions of advocacy groups. Participants were identified through their respective professional associations.


RESULTS
There were 306 responses and 260 were eligible for analysis; 45 medical oncologists, 125 urologists and 90 radiation oncologists. A total of 56% of physicians discharged GU cancer survivor follow-up care to a primary care practitioner (PCP) at some point after treatment. Compared to urologists and radiation oncologists, medical oncologists were least likely to share care with a PCP (4%). Only 47% of all physicians consistently provided a written follow up plan to the PCP and only 25% of these provided lifestyle recommendations. Lack of time and resources were the most commonly reported barriers. About half of physicians reported access to cancer rehabilitation programs as difficult and British Columbia was the most frequently cited region without access. Medical oncologists compared to other subspecialties accessed genetic counseling more easily while access to pain management programs was cited as the most difficult. In general, physicians in community hospitals had the most difficulties. Utilization of advocacy groups was limited, e.g. 23% for prostate cancer. The most underutilized advocacy group was for testis cancer (4%).


CONCLUSIONS
To our knowledge this is the first study to address the challenges of GU cancer survivorship care in Canada. The barriers to care and underutilization of advocacy groups quoted in this study may be used to stimulate nationwide initiatives to further long-term strategies in GU survivorship management planning.