Register      Login
Australian Health Review Australian Health Review Society
Journal of the Australian Healthcare & Hospitals Association
RESEARCH ARTICLE

Do Australian state and territory cancer plans include survivorship-related objectives and propose quality survivorship outcomes and measures?

Megan Petrie https://orcid.org/0000-0002-4825-7118 A B , Helana Kelly B and Michael Jefford https://orcid.org/0000-0002-8792-7807 B C *
+ Author Affiliations
- Author Affiliations

A Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Parkville, Vic. 3010, Australia.

B Australian Cancer Survivorship Centre, Peter MacCallum Cancer Centre, 305 Grattan Street, Melbourne, Vic. 3000, Australia.

C Sir Peter MacCallum Department of Oncology, University of Melbourne, Melbourne, Vic., Australia.

* Correspondence to: Michael.Jefford@petermac.org

Australian Health Review 47(3) 291-300 https://doi.org/10.1071/AH22295
Submitted: 21 February 2023  Accepted: 12 April 2023   Published: 4 May 2023

© 2023 The Author(s) (or their employer(s)). Published by CSIRO Publishing on behalf of AHHA.

Abstract

Objective This study reviewed Australian jurisdictional cancer plans to: (i) assess alignment of survivorship-related objectives with recommendations from the 2006 US Institute of Medicine (IOM) survivorship report, and (ii) identify objectives in assessing survivorship outcomes.

Methods Current government cancer plans were identified and reviewed for inclusion of survivorship-related objectives, which were coded based on alignment with the 10 IOM recommendations, as well as content relating to outcome assessment and measurement.

Results Twelve policy documents were identified from seven Australian states and territories. There was variability in the number of IOM recommendations addressed (between 3 and 8 of 10), the number of survivorship-related objectives (between 4 and 37 per jurisdiction) and the number of survivorship-related outcomes (between 1 and 25 per jurisdiction). Recommendations for raising awareness of survivorship, quality measures and models of survivorship care were more consistently addressed in jurisdictional plans. Recently updated plans appeared to have more survivorship-focused objectives. The importance of measuring survivorship outcomes was highlighted in all 12 cancer plans. Quality of life, other patient reported outcomes, and 5-year survival rates were the most commonly suggested outcomes. There was no consensus on metrics to assess survivorship outcomes, and little detail regarding how to measure proposed outcomes.

Conclusion Almost all jurisdictions included survivorship-focused objectives within cancer plans. There was considerable variation in (i) alignment with IOM recommendations, and (ii) focus on survivorship-related objectives, outcomes and outcome measures. Opportunity exists for collaboration and harmonisation of work to develop national guidelines and standards of quality survivorship care.

Keywords: Australia, cancer plan, cancer survivor, follow-up, models of care, outcomes, post-treatment care, quality of care, quality of life, surveillance, survival, survivorship, Victoria.


References

[1]  Torre LA, Siegel RL, Ward EM, Jemal A. Global Cancer Incidence and Mortality Rates and Trends—An Update. Cancer Epidemiol Biomarkers Prev 2016; 1 16–27.
Global Cancer Incidence and Mortality Rates and Trends—An Update.Crossref | GoogleScholarGoogle Scholar |

[2]  Cancer Council Australia. Australians living with and beyond cancer in 2040. Sydney: Cancer Council Australia; 2018. Available at https://www.cancer.org.au/assets/pdf/number-of-australians-living-with-or-beyond-cancer [cited 27 September 2021].

[3]  Australian Institute of Health and Welfare. Cancer summary data visualisation. Canberra: Australian Institute of Health and Welfare; 2021. Available at https://www.aihw.gov.au/getmedia/43903b67-3130-4384-8648-39c69bb684b5/Cancer-data-in-Australia.pdf.aspx?inline=true [cited 27 Sept 2021].

[4]  Hewitt M, Greenfield S, Stovall E. From Cancer Patient to Cancer Survivor: Lost in Transition. Washington, DC: National Academies Press; 2006

[5]  Jefford M, Rowland J, Grunfeld E, Richards M, Maher J, Glaser A. Implementing improved post-treatment care for cancer survivors in England, with reflections from Australia, Canada and the USA. Br J Cancer 2013; 108 14–20.
Implementing improved post-treatment care for cancer survivors in England, with reflections from Australia, Canada and the USA.Crossref | GoogleScholarGoogle Scholar |

[6]  Cancer Australia. Principles of Cancer Survivorship. Surrey Hills: Cancer Australia; 2017. Available at https://www.canceraustralia.gov.au/publications-and-resources/cancer-australia-publications/principles-cancer-survivorship [cited 27 September 2021].

[7]  Clinical Oncology Society of Australia Model of Survivorship Care Working Group. Model of Survivorship Care: Critical Components of Cancer Survivorship Care in Australia Position Statement. Clinical Oncology Society of Australia; 2016.

[8]  Lisy K, Langdon L, Piper A, Jefford M. Identifying the most prevalent unmet needs of cancer survivors in Australia: A systematic review. Asia Pac J Clin Oncol 2019; 15 e68–e78.
Identifying the most prevalent unmet needs of cancer survivors in Australia: A systematic review.Crossref | GoogleScholarGoogle Scholar |

[9]  Cancer Australia. Cancer Australia launches the development of the first Australian Cancer Plan. Surry Hills; Cancer Australia; 2021. Available at https://www.canceraustralia.gov.au/sites/default/files/2021_acp_australian_cancer_plan_communique.pdf [cited 27 September].

[10]  Australian Cancer Survivorship Centre. Victorian Quality Cancer Survivorship Care Framework. Melbourne: Australian Cancer Survivorship Centre; 2021. Available at https://www.petermac.org/victorian-quality-cancer-survivorship-care-framework [cited 27 September 2021].

[11]  Lisy K, Ly L, Kelly H, Clode M, Jefford M. How Do We Define and Measure Optimal Care for Cancer Survivors? An Online Modified Reactive Delphi Study. Cancers 2021; 13 2299
How Do We Define and Measure Optimal Care for Cancer Survivors? An Online Modified Reactive Delphi Study.Crossref | GoogleScholarGoogle Scholar |

[12]  Nekhlyudov L, Mollica MA, Jacobsen PB, Mayer DK, Shulman LN, Geiger AM. Developing a Quality of Cancer Survivorship Care Framework: Implications for Clinical Care, Research, and Policy. J Natl Cancer Inst 2019; 111 1120–1130.
Developing a Quality of Cancer Survivorship Care Framework: Implications for Clinical Care, Research, and Policy.Crossref | GoogleScholarGoogle Scholar |

[13]  Department of Health and Human Services. Victorian Cancer Plan 2020-2024 improving cancer outcomes for all Victorians. Melbourne: Victorian Government, Department of Health and Human Services; 2020. Available at https://www2.health.vic.gov.au/about/health-strategies/cancer-care/victorian-cancer-plan [cited 27 September 2021].

[14]  Mollica MA, Falisi AL, Geiger AM, Jacobsen PB, Lunsford NB, Pratt-Chapman ML, et al. Survivorship objectives in comprehensive cancer control plans: a systematic review. J Cancer Surviv 2020; 14 235–243.
Survivorship objectives in comprehensive cancer control plans: a systematic review.Crossref | GoogleScholarGoogle Scholar |

[15]  Department of Health and Human Services. Victorian cancer plan monitoring and evaluation framework: baseline report (2020). Melbourne: Victorian Government, Department of Health and Human Services; 2020. Available at https://www2.health.vic.gov.au/about/health-strategies/cancer-care/victorian-cancer-plan-monitoring-and-evaluation [cited 27 September 2021].

[16]  Cancer Institute NSW. NSW Cancer Plan. Sydney: Cancer Institute NSW; 2016. Available at https://www.cancer.nsw.gov.au/getmedia/69ca5241-3620-4898-a32b-e7c7e78cab8b/CancerPlan2016-Web.pdf [cited 27 September 2021].

[17]  Queensland Health. Cancer care statewide health service strategy. Brisbane: Queensland Health; 2014. Available at https://www.health.qld.gov.au/__data/assets/pdf_file/0028/621586/cancer-care-strategy.pdf [cited 27 September 2021].

[18]  Northern Territory Department of Health. Northern Territory Cancer Care Strategy 2018 to 2022. Darwin: Northern Territory Department of Health; 2019. Available at https://hdl.handle.net/10137/7486 [cited 27 September 2021].

[19]  Western Australian Department of Health. WA Cancer Plan 2020–2025. Perth: Health Networks, Western Australian Department of Health; 2020. Available at https://ww2.health.wa.gov.au/Reports-and-publications/WA-Cancer-Plan [cited 27 September 2021].

[20]  Western Australian Department of Health. WA Cancer Plan 2020–2025 priorities for implementation. Perth: Health Networks Unit, Western Australian Department of Health; 2021. Available at https://ww2.health.wa.gov.au/~/media/Corp/Documents/Health-for/Health-Networks/Cancer/WA-Cancer-Plan-2020-2025-Priorities-for-implementation.pdf [cited 27 September 2021].

[21]  WA Country Health Service. WA Country Health Service Cancer Strategy 2017–22. Perth: WA Country Health Service; 2017. Available at https://www.wacountry.health.wa.gov.au/~/media/WACHS/Documents/About-us/Publications/Strategic-plans/ED-CO-17-78038__eDoc_-_CO_-_WACHS_Cancer_Strategy_2017-2022_NOV_30_FINAL.pdf [cited 27 September 2021].

[22]  SA Health, Government of South Australia. Statewide Cancer Control Plan 2011-2015. Adelaide: SA Department of Health and The Cancer Council South Australia; 2011. Available at https://www.sahealth.sa.gov.au/wps/wcm/connect/Public+Content/SA+Health+Internet/About+us/Publications+and+Resources/Plans/State-wide+Cancer+Control+Plan+2011+2015 [cited 27 September 2021].

[23]  SA Health, Government of South Australia. South Australian Aboriginal Cancer Control Plan 2016-2021. Adelaide: Department for Health and Ageing; 2017. Available at https://www.sahealth.sa.gov.au/wps/wcm/connect/public+content/sa+health+internet/about+us/publications+and+resources/plans/south+australian+aboriginal+cancer+control+plan [cited 27 September 2021].

[24]  SA Health, Government of South Australia. SA Cancer Service Statewide Survivorship Framework. Adelaide: SA Health, Government of South Australia; 2018. Available at https://www.sahealth.sa.gov.au/wps/wcm/connect/Public+Content/SA+Health+Internet/About+us/Publications+and+Resources/Plans/South+Australian+Survivorship+Framework [cited 27 September 2021].

[25]  Tasmanian Department of Health. Cancer Framework and Strategic Cancer Plan 2010-2013. Hobart: Department of Health; 2013. Available at https://www.health.tas.gov.au/about_the_department/our_plans_and_strategies/cancer_framework_and_strategic_plan [cited 27 September 2021].

[26]  Bygrave A, Whittaker K, Paul C, Fradgley EA, Varlow M, Aranda S. Australian Experiences of Out-of-Pocket Costs and Financial Burden Following a Cancer Diagnosis: A Systematic Review. Int J Environ Res Public Health 2021; 18 2422
Australian Experiences of Out-of-Pocket Costs and Financial Burden Following a Cancer Diagnosis: A Systematic Review.Crossref | GoogleScholarGoogle Scholar |

[27]  Knott V, Zrim S, Shanahan EM, Anastassiadis P, Lawn S, Kichenadasse G, et al. Returning to work following curative chemotherapy: a qualitative study of return to work barriers and preferences for intervention. Support Care Cancer 2014; 22 3263–3273.
Returning to work following curative chemotherapy: a qualitative study of return to work barriers and preferences for intervention.Crossref | GoogleScholarGoogle Scholar |

[28]  Butow P, Laidsaar-Powell R, Konings S, Lim CYS, Koczwara B. Return to work after a cancer diagnosis: a meta-review of reviews and a meta-synthesis of recent qualitative studies. J Cancer Surviv 2020; 14 114–134.
Return to work after a cancer diagnosis: a meta-review of reviews and a meta-synthesis of recent qualitative studies.Crossref | GoogleScholarGoogle Scholar |

[29]  Cancer Institute NSW. NSW Cancer Plan 2022-2027. Sydney: Cancer Institute NSW; 2022. Available at https://www.cancer.nsw.gov.au/what-we-do/nsw-cancer-plan [cited 7 July 2022].