Survivorship care guidance in a diverse cancer survivor population: Cancer Registry for Understanding and Improving Survivorship Experiences (CRUISE) Study

PURPOSE: Using a population-based approach, the CRUISE Study is designed to understand disparities in receipt of survivorship care guidance among medically under-resourced cancer survivors. METHODS: Eligible participants identified from the Greater Bay Area Cancer Registry were those newly diagnosed with first primary stage I-III breast or colorectal cancer. Patients from medically under-resourced communities, defined on the basis of ethnic minority group, underinsurance, and/or living in a low socioeconomic status (SES) neighborhood, were oversampled. Using data derived from patient surveys, cancer registry, and geospatial linkage, patient, facility, and neighborhood attributes were assessed for associations with receipt of survivorship care guidance using univariate and multivariable log binomial regression models. RESULTS: Of 867 participants (332 breast cancer, 474 colorectal cancer), 62% identified with a non-White racial/ethnic group, 20.6% resided in a low SES neighborhood, and 9.3% were uninsured or publicly insured. Overall, 72.2% received survivorship care guidance. In a multivariable model, female breast cancer survivors relative to male colorectal cancer survivors (RR: 0.89, 95% CI: 0.81-0.97), and unemployed (RR: 0.80, 95% CI: 0.68-0.94) and retired (RR: 0.85, 95% CI: 0.77-0.95) versus employed people remained significantly less likely to receive guidance. Those who strongly agreed as well as those who disagreed that they could get medical care without financial setbacks were also significantly more likely to have received guidance than those who neither agreed nor disagreed (RR: 1.28, 95% CI: 1.09-1.51 for strongly agreed; RR: 1.22, 95% CI: 1.01-1.46 for disagreed). CONCLUSIONS: The CRUISE Study demonstrated feasibility in accruing a population-based sample of cancer survivors with over-representation of medically under-resourced patients. IMPLICATIONS FOR CANCER SURVIVORS: A high proportion received survivorship guidance, including survivorship care plans or post-treatment guidance, but some variations were found across some patient characteristics.