International survey of psychosocial care for cancer survivors in low/middle and high-income countries: current practices, barriers, and facilitators to care

Signorelli, C. and Høeg, B. and Asuzu, C. and Centeno, I. and Estapé, T. and Fisher, P. and Lam, W. and Levkovich, I. and Manne, S. and Miles, Anne and Mullen, L. and Nekhlyudov, L. and Sade, C. and Shaw, J. and Singleton, A. and Travado, L. and Tsuchiya, M. and Lemmen, J. and Li, J. and Jefford, M. (2024) International survey of psychosocial care for cancer survivors in low/middle and high-income countries: current practices, barriers, and facilitators to care. JCO Global Oncology 10 , ISSN 2687-8941.

Abstract

Purpose: The number of cancer survivors living with and beyond cancer treatment is rising globally. It is fundamental to understand the extent and type of psychosocial care services offered worldwide. We evaluated models of cancer survivorship care, psychosocial care practices in the post-treatment survivorship phase, and barriers/facilitators to delivery of psychosocial care services, including in low and middle-income countries (LMICs). Patients and Methods: The International Psycho-Oncology Society (IPOS) Survivorship Special Interest Group led a cross-sectional online survey between March and November 2022. Healthcare professionals and researchers in psycho-oncology were invited through the IPOS global membership, social media, and snowballing. The survey was administered to individuals but included questions relating to practices in their country at a national level. Results: 283 respondents from 37 countries participated (40% from LMICs), with a median of 12 years’ experience (IQR=6-20) in the psycho-oncology field. Participants reported that the most common elements of routine survivorship care were related to the prevention/management of recurrences/new cancers (74%), physical late effects (59%), and chronic medical conditions (53%), while surveillance/management of psychosocial late effects (27%) and psychosocial/supportive care (25%) were least common. Service availability was more commonly reported in HICs than LMICs relating to reproductive health (29% vs 17%), genetic counselling/support (40% vs 20%), and to identify/manage distress (39% vs 26%) and pain (66% vs 48%). Key barriers included providers focusing on ‘treatment not survivorship’ (57%) and on ‘medical not psychosocial care’ (60%), and a lack of allied health providers to deliver psychosocial care (59%). Conclusion: The psychosocial needs of people with cancer are not adequately available and/or provided in post-treatment survivorship even in HICs, due to barriers at patient-, provider- and system-levels.

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