Oncologists fail to promote healthy living for cancer survivors

  • Stump TK & al.
  • Cancer
  • 26/08/2019

  • Yael Waknine
  • Clinical Essentials
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Takeaway

  • Few oncologists and specialists promote healthy lifestyles to cancer survivors, despite the recommendation in 2018 and 2019 guidelines.

Why this matters

  • 2018 and 2019 practice guidelines advise clinicians, including oncologists, to promote healthy lifestyles among cancer survivors.
  • The authors note that prior research shows 80% of cancer survivors express interest in health-promotion advice, yet .

Study design

  • Mixed-method survey of 30 primary care physicians (PCPs), 30 oncologists, and 31 specialists (urologists, dermatologists, and gynecologists).
  • Funding: NIH.

Key results

  • 26.7% of oncologists and 9.7% of specialists reported ever recommending health promotion (e.g., weight loss, smoking cessation) to cancer survivors vs 90% of PCPs (P<.001 style="list-style-type:circle;">
  • Oncologists and specialists were also less likely to provide relevant referrals (P<.01>
  • 92.3% overall would not discuss health promotion in patients with comorbid cardiometabolic disease.
  • Most clinicians believed that ≥50% of survivors would adhere to recurrence prevention regimens, but adherence would decline with attempted weight loss (predicted: 57.0% to 10.7%; P<.05>
  • Patient interest was commonly mentioned as a factor for health-promotion conversations.
  • Oncologists expressed concern that health promotion would distress or overwhelm patients.
  • Additional barriers to health promotion included oncologists’ focus on cancer control, time pressure, insufficient training, and challenges of coordinating care.
    • Positive factors included perceived patient benefit and integrated health-promotion resources.
  • Limitations

    • Single Midwestern health care system.