||1R01CA241128-01 Interpret this number
||University Of California, San Francisco
||Cancer Registry for Understanding and Improving Survivorship Experiences (CRUISE)
There are currently an estimated 15.5 million cancer survivors in the U.S., which is expected to increase in
number and racial/ethnic diversity. Cancer survivors face many unique challenges, including late and long-term
health effects, emotional and financial hardships, and a greater risk for developing second cancers and other
serious health conditions. These challenges may be even more prevalent among underserved populations. In
2006, the Institute of Medicine (IOM) recommended the widespread implementation of survivorship care plans
(SCPs) to facilitate the transition from active treatment to cancer survivorship, from oncology care to primary
care. SCPs are intended to encompass the details of cancer treatment, which can be shared with current and
future medical providers; anticipatory education for survivors; and provision of information about available
resources relating to survivorship needs. The recommendations call for oncology treatment teams to review
SCPs with patients at the conclusion of their cancer treatment. Early research in the years since the IOM
recommendations has shown that implementation of SCPs is not widespread, evidence of improved survivor
outcomes is limited, and there is considerable variation in the content of SCPs, with many plans failing to
adhere to all of the IOM recommendations. Moreover, there is virtually no research on whether existing SCPs
are culturally- or linguistically-tailored to patients and whether they address key social determinant barriers
among underserved patients. More research is needed to thoroughly explore the efficacy and viability of SCPs
in real-world settings. Specifically, while previous research has uncovered key cultural differences in
survivorship experiences, we still know little about the appropriateness, effectiveness, and implementation of
SCPs among cancer survivors from diverse racial/ethnic, cultural, and socioeconomic backgrounds. The
overarching goal of this proposal is to investigate the extent to which SCPs are implemented in clinical care
and used among diverse and underserved populations of breast and colorectal cancer survivors in California.
Leveraging population-based cancer registries, we therefore propose the Cancer Registry for Understanding
and Improving Survivorship Experiences (CRUISE) project, which takes a comprehensive, multi-level approach
to examine the implementation of, and patient experiences with, SCPs, with focus on underserved populations.
Our aims are as follows: 1) to examine the use and effectiveness of SCPs on patient-reported outcomes in
breast and colorectal cancer survivors in the Greater San Francisco Bay Area; 2) to investigate the
implementation and content of survivorship strategies and support including SCPs in use in California health
systems serving diverse cancer patient populations; and 3) to convene a Delphi panel of stakeholders to
develop best practices for delivering SCPs to meet the needs of diverse patient populations. The current
proposal will advance our understanding of the implementation and effectiveness of SCPs from both the
perspective of survivors and healthcare systems, focusing in particular on underserved patient populations.
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