Jennifer M. Jones, Rogih Andrawes, Michelle A. Weller, Adrienne Lam, Gilla K. Shapiro, Madeline Li, Danielle Rodin, Lisa Avery
{"title":"在加拿大最大的综合癌症中心检查转介到癌症康复模式和预测因素的病例对照研究","authors":"Jennifer M. Jones, Rogih Andrawes, Michelle A. Weller, Adrienne Lam, Gilla K. Shapiro, Madeline Li, Danielle Rodin, Lisa Avery","doi":"10.1002/cam4.71046","DOIUrl":null,"url":null,"abstract":"<div>\n \n \n <section>\n \n <h3> Background</h3>\n \n <p>Cancer rehabilitation has become increasingly relevant as the number of cancer survivors grows, coupled with the high-documented rates of adverse effects and related disability. Cancer rehabilitation can reduce functional limitations among cancer survivors and enhance their well-being. However, only a small proportion of individuals are referred to rehabilitation services. To identify and address disparities and foster access, it is essential to develop a better understanding of the factors that drive referral to cancer rehabilitation services.</p>\n </section>\n \n <section>\n \n <h3> Methods</h3>\n \n <p>The purpose of this study was to: (1) describe the sociodemographic and clinical characteristics and symptom burden of patients who were referred to the Princess Margaret Cancer Rehabilitation and Survivorship (CRS) Program between 2017 and 2019 and (2) Compare these variables between patients who were referred to CRS (<i>n</i> = 2783) and matched cases who were not referred over this period (<i>n</i> = 18,434). A retrospective secondary analysis of data extracted from the Princess Margaret (PM) Cancer Registry, electronic patient records, and patient-reported outcome data (PROMs) (including ESAS-r and ECOG status) was performed. Summary statistics were used to describe the patients referred to the CRS program. Multivariable logistic regression modelling was used to identify factors associated with likelihood of referral.</p>\n </section>\n \n <section>\n \n <h3> Results</h3>\n \n <p>Most referred patients were female (74%), English speakers (93%) and half lived within 15 km of the referred hospital. The most common reasons for referral were musculoskeletal impairment (26%) and lymphedema (25.4%). Many patients (45%) had multiple reasons for referral. Several key predictors of referral were identified including closer distance to hospital, lower age (< 65 years), cancer site, and completion of PROMs. For those who completed PROMs, patient reported function status and pain scores were related to referral.</p>\n </section>\n \n <section>\n \n <h3> Conclusion</h3>\n \n <p>The findings can be helpful in optimizing the referral processes and addressing disparities regarding access to cancer rehabilitation. Solutions are likely multifaceted including health care provider and patient education and systemic changes to address barriers.</p>\n </section>\n </div>","PeriodicalId":139,"journal":{"name":"Cancer Medicine","volume":"14 13","pages":""},"PeriodicalIF":3.1000,"publicationDate":"2025-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/cam4.71046","citationCount":"0","resultStr":"{\"title\":\"A Case Control Study Examining the Patterns and Predictors of Referral to Cancer Rehabilitation at Canada's Largest Comprehensive Cancer Centre\",\"authors\":\"Jennifer M. Jones, Rogih Andrawes, Michelle A. Weller, Adrienne Lam, Gilla K. Shapiro, Madeline Li, Danielle Rodin, Lisa Avery\",\"doi\":\"10.1002/cam4.71046\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div>\\n \\n \\n <section>\\n \\n <h3> Background</h3>\\n \\n <p>Cancer rehabilitation has become increasingly relevant as the number of cancer survivors grows, coupled with the high-documented rates of adverse effects and related disability. Cancer rehabilitation can reduce functional limitations among cancer survivors and enhance their well-being. However, only a small proportion of individuals are referred to rehabilitation services. To identify and address disparities and foster access, it is essential to develop a better understanding of the factors that drive referral to cancer rehabilitation services.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Methods</h3>\\n \\n <p>The purpose of this study was to: (1) describe the sociodemographic and clinical characteristics and symptom burden of patients who were referred to the Princess Margaret Cancer Rehabilitation and Survivorship (CRS) Program between 2017 and 2019 and (2) Compare these variables between patients who were referred to CRS (<i>n</i> = 2783) and matched cases who were not referred over this period (<i>n</i> = 18,434). A retrospective secondary analysis of data extracted from the Princess Margaret (PM) Cancer Registry, electronic patient records, and patient-reported outcome data (PROMs) (including ESAS-r and ECOG status) was performed. Summary statistics were used to describe the patients referred to the CRS program. 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A Case Control Study Examining the Patterns and Predictors of Referral to Cancer Rehabilitation at Canada's Largest Comprehensive Cancer Centre
Background
Cancer rehabilitation has become increasingly relevant as the number of cancer survivors grows, coupled with the high-documented rates of adverse effects and related disability. Cancer rehabilitation can reduce functional limitations among cancer survivors and enhance their well-being. However, only a small proportion of individuals are referred to rehabilitation services. To identify and address disparities and foster access, it is essential to develop a better understanding of the factors that drive referral to cancer rehabilitation services.
Methods
The purpose of this study was to: (1) describe the sociodemographic and clinical characteristics and symptom burden of patients who were referred to the Princess Margaret Cancer Rehabilitation and Survivorship (CRS) Program between 2017 and 2019 and (2) Compare these variables between patients who were referred to CRS (n = 2783) and matched cases who were not referred over this period (n = 18,434). A retrospective secondary analysis of data extracted from the Princess Margaret (PM) Cancer Registry, electronic patient records, and patient-reported outcome data (PROMs) (including ESAS-r and ECOG status) was performed. Summary statistics were used to describe the patients referred to the CRS program. Multivariable logistic regression modelling was used to identify factors associated with likelihood of referral.
Results
Most referred patients were female (74%), English speakers (93%) and half lived within 15 km of the referred hospital. The most common reasons for referral were musculoskeletal impairment (26%) and lymphedema (25.4%). Many patients (45%) had multiple reasons for referral. Several key predictors of referral were identified including closer distance to hospital, lower age (< 65 years), cancer site, and completion of PROMs. For those who completed PROMs, patient reported function status and pain scores were related to referral.
Conclusion
The findings can be helpful in optimizing the referral processes and addressing disparities regarding access to cancer rehabilitation. Solutions are likely multifaceted including health care provider and patient education and systemic changes to address barriers.
期刊介绍：
Cancer Medicine is a peer-reviewed, open access, interdisciplinary journal providing rapid publication of research from global biomedical researchers across the cancer sciences. The journal will consider submissions from all oncologic specialties, including, but not limited to, the following areas:
Clinical Cancer Research
Translational research ∙ clinical trials ∙ chemotherapy ∙ radiation therapy ∙ surgical therapy ∙ clinical observations ∙ clinical guidelines ∙ genetic consultation ∙ ethical considerations
Cancer Biology:
Molecular biology ∙ cellular biology ∙ molecular genetics ∙ genomics ∙ immunology ∙ epigenetics ∙ metabolic studies ∙ proteomics ∙ cytopathology ∙ carcinogenesis ∙ drug discovery and delivery.
Cancer Prevention:
Behavioral science ∙ psychosocial studies ∙ screening ∙ nutrition ∙ epidemiology and prevention ∙ community outreach.
Bioinformatics:
Gene expressions profiles ∙ gene regulation networks ∙ genome bioinformatics ∙ pathwayanalysis ∙ prognostic biomarkers.
Cancer Medicine publishes original research articles, systematic reviews, meta-analyses, and research methods papers, along with invited editorials and commentaries. Original research papers must report well-conducted research with conclusions supported by the data presented in the paper.
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