Assessment of distress, unmet needs, and receipt of care plans among cancer survivors in Georgia

Background: Cancer survivors have distinctive healthcare needs. The Survivorship Working Group of the Georgia Cancer Control Consortium conducted an assessment to understand the physical, psychological, practical, and spiritual needs of adult cancer survivors; patient perceptions regarding patient-provider communications; and their perceived need for services. Methods: In 2014, a convenience sample of Georgia cancer survivors completed a paper or online survey about the presence of and distress associated with unmet physical, emotional, spiritual, and practical needs, and receipt of assistance in those areas. They were also asked about receipt of cancer treatment and survivorship care plans. Results: Survivors were primarily female, married, White, and within 5 years of treatment. High proportions reported moderate to extreme levels of distress with depression (32.7%), anxiety (32.1%), stress (30.2%), and fear of recurrence (28.2%). Many reported no receipt of assistance in emotional needs such as changing relationships and defining a new normal and physical needs such as intimacy and body image. Fewer than half (48%) reported having received a cancer treatment summary from their physician and only 37% received a survivorship care plan. Of those who received either, 98% reported that the information was helpful. Conclusions: Cancer survivors in Georgia who responded to the survey had unmet needs, especially related to physical and mental health. More widespread adoption of guidelines of the Commission on Cancer, including the use of distress screening tools, would assist providers in addressing identified needs directly or through referrals. A limitation is that the racial and ethnic minority participation of 20.1% is insufficient to generalize results to all cancer survivors in Georgia. Subsequent surveys would benefit from targeted approaches to reach diverse and underserved survivors.