Abstract
BackgroundLong‐term medico‐social follow‐up of cancer survivors is a challenge because of frequent subsequent troubles. In particular survivors with lower health literacy (HL) have poorer health and might more often use primary care services. However, the impact of HL on cancer survivors’ medico‐social follow‐up visits is not known. Our aim was to study medico‐social follow‐up and its associated determinants with a focus on HL 5 years after diagnosis.MethodsVICAN is a national survey of French adult cancer survivors 5 years after a primary cancer. The Single‐Item Literacy Screener was used to define functional HL in this sample. We also asked patients to report the frequency of follow‐up visits with a general practitioner (GP) and/or social worker (SW) regarding their cancer disease.ResultsThe 4045 participants were 57.4 ± 12.9 years old at diagnosis (range 20‐82) and 1495 (37%) were classified as having inadequate HL. Most cancer survivors (66.7%) were followed up by a GP regarding their cancer while only 14.5% had contact with a SW. After adjustment for sociodemographic, medical, and psychosocial characteristics, medico‐social follow‐ups (GP and SW visits) were more frequent among survivors with low HL. Furthermore, low income, unemployment, impaired mental health, treatment by chemotherapy, and perception of sequelae and fatigue were also associated with more frequent medico‐social follow‐up. Cancer localization association with medico‐social follow‐up was heterogeneous.ConclusionFrench cancer survivors with limited HL, lower socioeconomic status, and more severe cancer were more likely to use GP care and social services. Raising awareness and training GPs and SWs on medico‐social follow‐up for patients with limited HL seem necessary to support these vulnerable survivors.
Highlights
We asked patients to report the frequency of follow-up visits with a general practitioner (GP) and/or social worker (SW) regarding their cancer disease
Medico-social follow-up The medical follow-up corresponded to follow-up visits by a GP and was evaluated with a question asking, “Do you consult your general practitioner for the follow-up of your cancer?” Social care follow-up was self-reported asking, “Following your cancer, have you been in contact with a social worker?”
Of the 4 174 patients who participated in the VICAN5 study, 96.9% have completed the Single Item Literacy Screener (SILS)
Summary
The prevalence of cancer is rising globally.[1]. As cancer has often evolved from a life-threatening disease into a chronic illness, a large number of patients will become long-term survivors. In countries like France, where the general practitioner (GP) is at the center of primary care, the medical authorities suggest integrating the GP very early in the oncology care of their patients so that later these GPs continue to ensure the long-term follow-up of cancer survivors.[6]. In public hospitals and specialized care centers, access to a specialist is completely free of charge but the delay to get an appointment can be long. To overcome these difficulties, some patients use specialists in the private sector. Long-term medico-social follow-up of cancer survivors is a challenge because of frequent subsequent troubles. Raising awareness and training GPs and SWs on medico-social follow-up for patients with limited HL seem necessary to support these vulnerable survivors
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