Cancer survivorship is a testament to medical advancements, but the journey doesn’t end with treatment. Survivors face the ongoing risk of recurrence and the potential for developing new cancers, highlighting the crucial role of continued screening for common cancers like breast and cervical cancer. This article explores the significance of comprehensive follow-up instructions in promoting adherence to these vital screenings, drawing upon insights from Dr. Mariam F. Eskander, MD, MPh, a surgical oncologist and Assistant Professor of Surgery at the Rutgers Cancer Institute of New Jersey.
Dr. Eskander presented research at the 2023 American Society of Clinical Oncology (ASCO) Annual Meeting that underscores the impact of survivorship care plans on post-treatment screening for breast and cervical cancers. Her work emphasizes the simple yet powerful act of providing clear follow-up instructions, which can significantly increase a survivor’s likelihood of undergoing recommended screenings.
The Impact of Screening on Long-Term Outcomes
With millions of cancer survivors in the United States, the focus on long-term health and well-being is paramount. While the risk of primary cancer recurrence remains, survivors also face the same risks for common cancers as the general population. Regular screenings, such as mammograms for breast cancer and Pap smears for cervical cancer, are essential for early detection and improved survival rates. As cancer treatments improve and survivors live longer, addressing the risk of developing new cancers becomes increasingly important.
Findings on Breast and Cervical Cancer Screenings
Dr. Eskander’s study examined a cohort of women with a history of cancer who were eligible for both breast cancer screening (BCS) and cervical cancer screening (CCS). The research aimed to understand how different components of survivorship care, particularly follow-up instructions, influence post-treatment screening adherence. The results revealed a strong correlation between receiving follow-up instructions and undergoing recommended screenings. Women who reported receiving these instructions were significantly more likely to get screened for both breast and cervical cancers.
The Gap in Providing Follow-Up Instructions
The study also brought to light a concerning statistic: approximately 25% of healthcare providers did not provide patients with follow-up instructions for future screenings. Several factors might contribute to this gap. Recall bias, where patients may not accurately remember receiving instructions, is a possibility. However, the findings also suggest a potential systemic issue within healthcare delivery, where providing consistent follow-up instructions may not be prioritized as it should be.
The Power of Clear Communication
Dr. Eskander highlights the remarkable impact of simply providing follow-up instructions. The study demonstrated that receiving these instructions increased the likelihood of undergoing breast cancer screening by almost 50% and cervical cancer screening by a staggering 250%. This underscores the importance of clear communication and proactive guidance in empowering survivors to take charge of their long-term health.
Disparities in Screening Rates
The research suggests higher screening rates for cervical cancer compared to breast cancer after receiving follow-up instructions. This disparity might be attributed to differences in screening recommendations. For instance, a human papillomavirus (HPV) test within the past 5 years qualifies as CCS, while maintaining up-to-date BCS requires mammograms every 2 years. The more frequent requirement for BCS could contribute to lower adherence. Recall bias and demographic factors could also play a role in these observed differences.
Addressing Psychological Barriers
Beyond practical considerations, psychological factors can significantly influence a survivor’s willingness to undergo screening. The emotional toll of cancer treatment can create barriers, ranging from fear of recurrence to a sense of invincibility that diminishes the perceived need for further screening. Healthcare providers play a crucial role in addressing these psychological barriers by emphasizing the ongoing importance of screening for both primary cancer recurrence and new cancers.
Optimizing Survivorship Care Plans
Integrating follow-up instructions into survivorship care plans is essential for improving screening adherence. Written instructions outlining a clear schedule for both primary cancer surveillance and routine cancer screenings are more effective than general recommendations. Structured plans, specifying when and where to obtain checkups, empower survivors to prioritize their health and follow through with recommended screenings.
Future Research Directions
Dr. Eskander’s research opens doors for further investigation into optimizing survivorship care. Understanding why some patients do not receive follow-up instructions and developing strategies to enhance the effectiveness of these instructions are key areas for future research. Exploring different formats for delivering instructions and tailoring them to individual needs can further improve adherence and long-term health outcomes.
Conclusion
The importance of clear and comprehensive follow-up instructions for cancer survivors cannot be overstated. These instructions empower survivors to actively participate in their long-term care, increasing the likelihood of undergoing essential screenings for breast and cervical cancers. By prioritizing effective communication and addressing both practical and psychological barriers, healthcare providers can significantly improve the health and well-being of cancer survivors. For personalized treatment plans and survivorship care, consult with a healthcare professional.
