Few Oncologists Suggest Health Promotion to Cancer Survivors

Few oncologists and specialists recommend health promotion to cancer survivors, according to a study published online in Cancer.

Noting that guidelines encourage health promotion counseling for cancer survivors, Tammy K. Stump, Ph.D., from the Northwestern University Feinberg School of Medicine in Chicago, and colleagues examined the extent of physician adherence. A total of 91 physicians were surveyed, including 30 primary care physicians (PCPs), 30 oncologists, and 31 specialists (urologists, dermatologists, and gynecologists) in a mixed-method survey. Twelve oncologists were also interviewed.

The researchers found that 90 percent of PCPs reported recommending health promotion to at least some cancer survivors, while few oncologists and specialists reported ever doing so (26.7 and 9.7 percent, respectively). Most physicians believed that at least half of cancer survivors would be adherent to medication regimens to prevent recurrence but would not remain medication-adherent if trying to lose weight. When interviewed, oncologists expressed concern that health promotion could distress or overwhelm patients. Thematic analysis identified additional health promotion barriers, including identifying cancer as oncologists' focal concern, time pressure, insufficient training in behavior change, and challenges of care coordination. Perceiving a patient benefit and having health-promotion resources integrated into the cancer care system were identified as facilitators.

"Systems-level solutions, such as providing health promotion through survivorship clinics, could help to ameliorate the barriers identified in this study and close the gap in delivery of needed behavior change services to cancer survivors," the authors write.

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