IDENTIFYING FRAILTY IN CANCER SURVIVORS: PATTERNS OF CANCER FOLLOW-UP CARE AND IMPLICATIONS FOR PERSONALIZED SURVIVORSHIP MODELS

Abstract

Improved cancer care has increased the number of survivors, straining Canada’s cancer care system. As survivors age, they may become frail, resulting in complex needs better addressed through alternative care models. No research has examined health services use in frail cancer survivors or quantified frailty within a Canadian cancer survivor population. This thesis estimated the burden of frailty amongst Nova Scotia cancer survivors diagnosed with stage I-III breast, colorectal, gynecologic, or prostate cancer between Jan 2006-Dec 2013, from the provincial Cancer Registry (n=10,176). Then, it characterized differences in survivors’ patterns of follow-up care by frailty and other characteristics. The prevalence of frailty amongst the survivor population was 17.7%. Compared to non-frail cancer survivors, frail survivors had 58% greater odds of having a high (versus low-medium) proportion of primary care provider visits (Odds Ratio 1.58, 95% CI 1.43-1.76). Future research should investigate how primary care models can best support frail survivors.