Financial concerns: a critical gap in survivors’ experience of the implementation of the national standards for cancer survivorship care

It is vitally important to comprehensively identify and address cancer survivors’ unmet needs. The new national standards for cancer survivorship care may improve survivorship care by defining quality care. The purpose of this convergent mixed-methods study was to describe how survivorship care at one cancer center aligns with the health system processes outlined in the national standards. Survey participants (N = 150) were survivors purposively sampled by treatment status, cancer stage, and geographic residence. Survey data evaluated how well providers assessed, listened to, and managed participants’ concerns across key domains and were primarily analyzed descriptively. Survey data were complemented by semi-structured interview data from n = 17 survivors, which were analyzed using directed content analysis. Greater than 70% of participants reported that their providers regularly assessed and listened to physical and emotional concerns. Fewer than 30% reported regular assessment of financial and insurance concerns. Once identified, most concerns were adequately managed by care teams, the exception being practical concerns. Interviewees highlighted quality survivorship care in general with some internal and external barriers. Participants recommended increasing awareness of available services and improving care coordination and navigation related to survivorship care. Results suggest that while survivorship care may align with the national standards related to physical and emotional concerns, there is critical need to improve assessment and management of financial concerns. Cancer centers should conduct comprehensive screening that includes financial and other practical concerns and implement processes for connecting survivors with needed services.