Needs assessment for cancer survivors and implications for cancer survivorship care delivery and research.

Abstract

438 Background: The growing demographic of cancer survivors continues to experience persistent needs in the post-treatment phase, with delayed and long-term side effects, emotional and psychological issues, practical and social effects of cancer, health maintenance, and cancer surveillance. The National Cancer Institute recently identified needs assessment for referral and providing access to care as integral to survivorship care. Methods: This study was implemented as a quality improvement project at an NCI-designated cancer center survivorship program. We adapted the NCCN survivorship assessment questionnaire into an Electronic Medical Records embedded questionnaire sent to patients prior to each cancer survivorship visit. For questionnaires completed more than once, only the first response was included in the analysis. Paper questionnaires were excluded. We generated descriptive statistics and used the chi-square test to compare groups. Results: A total of 1796 unique patients completed the questionnaire from 2016 to March 2026. Patients were racially and ethnically diverse: Asian (17%), Black/African American (3%), Hispanic (10%), and White (62%). The median age was 64 years. Breast (27%) and colon (33%) cancer patients were the largest groups; other cancers included GI cancers (e.g., gastric, pancreas, neuroendocrine). Respondents were primarily female (67%). The top concerns were not meeting the exercise recommendations (45%), fatigue (39%), weight changes (38%), sleep problems (37%), tingling and numbness (35%), pain (32%), memory difficulty (30%), and anxiety (30%). As compared to colon cancer survivors, breast cancer survivors reported higher fatigue (45% versus 35%, p <0.0008), and a tingling and numbness score of 5 on a scale of 10 (30% versus 23%, p <0.04). Reports of tingling and numbness were higher in colon cancer survivors overall (30% versus 40%, p <0.021). Women reported fatigue at higher rates than men (42% versus 29%, p <0.001) and similar rates of tingling and numbness (33% vs. 36%, p <0.2). Conclusions: In this real-world implementation of a needs assessment process for cancer survivors, we identified numerous needs of cancer survivors for tailoring survivorship care. We also identified that providing access to and referrals for exercise programs, and addressing fatigue, weight changes, sleep, tingling and numbness, and memory difficulties, are priorities for survivorship care delivery. Our findings also highlight the utility of the needs assessment and opportunities for further research.