Intersection of characteristics including active decision-making and health literacy with health system-related factors including care coordination, and the association with health-related quality of life in cancer survivors

People are more likely than ever to survive past treatment for cancer, and survivors represent a rapidly growing population. Therefore, maximizing health-related quality of life (HRQoL) after treatment has become immensely important.

In aim one we found that individuals actively involved in selecting their surgeon may have been more likely to receive surgery at a hospital that was larger or recognized for quality cancer care, and they had higher post-treatment HRQoL. Based on our results, further research is warranted to investigate how to overcome the barriers to active decision-making to allow patients to make informed choices.

In aim two we examined the relationship between having a cancer care coordinator (CCC) and post-treatment HRQoL. In addition, we evaluated this relationship by health literacy, which plays an important role in patients’ ability to navigate the healthcare system. Participants with low health literacy who had a CCC had significantly higher physical HRQoL scores compared to those who did not, while not so for those with higher health literacy. Future studies should attempt to determine the mechanisms by which CCCs improve survivorship HRQoL.

In aim three we found that receiving a Survivorship Care Plan, which is an informational resource designed to help individuals transition to survivorship, improved physical HRQoL after treatment, but specifically for individuals with high health literacy who were more able to read and utilize the information. Further research is needed to identify other survivorship resources for people with lower health literacy that can aid the transition from treatment to survivorship.