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Introduction: Cancer patients in Australia's Northern Territory (NT) face unique challenges to accessing cancer-related community and allied health services (referred here as 'health services'). This is in part due to the NT's unique geographic, socioeconomic and demographic profile. This paper describes the use of health services by cancer patients in the NT.Methods: Adult cancer patients attending appointments at a cancer centre in Darwin, NT and who were diagnosed within the past five years were invited to participate in face-to-face interviews about their use of allied and community health services. A descriptive analysis of health services utilization was conducted.Results: Of the 76 participants interviewed, 63% identified as non-Indigenous, 53% female and 45% lived in very remote areas. Mean age at interview was 58.7 years (SD 13.2). Overall, 82% of participants utilized at least one health service since their cancer diagnosis. All Indigenous participants used at least one service, while 28% of non-Indigenous participants did not use any health service. The services most frequently used by participants were community services (42%) and information sources (40%).Conclusion: The findings from this study suggest there is variation in the type of community and allied health services used by NT cancer patients across clinical and demographic groups (including Indigenous status). Further qualitative enquiry is needed to better understand this variation, which may reflect differences in service preference, accessibility, health literacy of patients or patient engagement. Such knowledge may inform service delivery improvements to better support cancer patients through their cancer care pathway. [ABSTRACT FROM AUTHOR]

Purpose: Improvement in treatment has extended survival of breast cancer patients. Our study aimed to characterize health service use among long-term breast cancer survivors in Israel in order to identify and address specific needs of this subpopulation.Methods: The study population included 250 women diagnosed with breast cancer, 8-12 years prior to study initiation (cases), and 250 individually matched cancer-free controls. Participants were recruited from the second largest Israeli HMO, and data were collected through personal interviews. ORs and 95 % CIs were estimated using conditional logistic regression and generalized estimating equations.Results: Greater use of health services was observed among cases, compared to an age-matched comparison group, expressed by more visits to family physicians and specialists, longer duration of visits, more requests for referrals, more frequent contact with emergency services, and hospitalizations. The study groups were similar regarding socioeconomic variables, current smoking and physical activity, BMI, and prevalence of reported morbidity. Although 80 % of cases defined the family physician as their main treating physician, half still considered their oncologist responsible for cancer follow-up. Only 14.4 and 10.4 % of cases and controls, respectively, reported receiving psychological support during the year preceding the interview.Conclusions: Further studies should assess the contribution of apprehension concerning health-related issues that still accompany breast cancer survivors, to the excess use of health services. Concern among family practitioners may contribute as well. In addition, our results emphasize the need to improve coordination between the disciplines of oncology and community medicine for the medical care of this group. [ABSTRACT FROM AUTHOR]

Purpose: Individuals with cancer frequently report significant gaps in information, support, and health care service navigation at diagnosis and in the survivorship phase. A comprehensive web-based tool called the Oncology Interactive Navigator™ (OIN) appears promising in addressing these gaps. The present qualitative inquiry explores the perceptions of individuals concerning the OIN™, as a complementary resource to support psychosocial adjustment to cancer and guide access to cancer care services. Method: As part of a pilot multi-method multi-site study, 151 individuals newly diagnosed with colorectal cancer or melanoma were offered unrestricted access to the OIN™ for 8 weeks. Qualitative interviews were undertaken with a subset of participants ( n = 20) to explore their experience with the tool. Interviews were digitally audio-recorded and transcribed verbatim. Results: The OIN™ was reported to be instrumental in fulfilling participants' cancer information and supportive care needs, particularly early in the cancer trajectory. More specifically, the tool was seen as a 'go to' resource to obtain more detailed information, validate information provided elsewhere, and pace exposure to cancer information. Content also was perceived to be of high quality, practical, and comprehensive. All participants underscored how the tool improved their cancer knowledge, facilitated communication, and prepared them for subsequent medical consultations. Conclusion: Given the rapid proliferation of web-based tools of varying scope, quality, and relevance, the exploration of users' perspectives is key to informing the development, refinement, implementation, and sustainability of promising web-based tools such as the OIN™. [ABSTRACT FROM AUTHOR]

Purpose: Fear of cancer recurrence (FCR) is common and associated with younger age. This study aimed to explore the prevalence and correlates of FCR amongst younger survivors of early breast cancer. Subjects: A total of 218 women aged 18-45 were diagnosed with stage 0-2 breast cancer at least 1 year earlier. Methods: The participants completed a web-based survey including a validated measure of FCR and items exploring medical surveillance practices and health care use. Results: A total of 70% of participants reported clinical levels of FCR. Higher FCR was associated with higher frequency of unscheduled visits to the GP, higher frequency of breast self-examination and other forms of self-examination for cancer, not having mammograms or ultrasounds or other forms of cancer screening in the past year, more complementary therapy use and the use of counselling and support groups. Conclusions: Young women with breast cancer are particularly vulnerable to FCR. The present study provides preliminary evidence that FCR is associated with higher health costs and lower surveillance rates which may compromise health outcomes. Routine screening for FCR in follow-up care is recommended. [ABSTRACT FROM AUTHOR]

Background: The population of people surviving cancer is continually increasing and currently cancer survivors represent approximately 3.7% of the American population and 3% of the UK population. There is limited and inconclusive empirical evidence regarding the long-term health and well-being of cancer survivors. Methods: Two hundred eighty-nine cancer survivors and 262 matched-age and sex patients from the same group of General (primary care) Practices completed postal questionnaires measuring health and well-being, health service utilisation and satisfaction and health care needs. Main Results: Cancer survivors reported poorer health and well-being and health service utilisation than the general population. Despite this poorer health, the majority of cancer survivors reported satisfaction with services and almost two-thirds of the survivors did not report any needs. Conclusions: The majority of cancer survivors do not appear to require additional support services. There is, however, a subgroup of survivors who warrant specialist support, particularly survivors who are older, experience late effects and have had adjuvant treatments. Future research should focus on developing methods that could be used in routine clinical practice to identify 'at risk' or vulnerable patients and to provide appropriate and timely support. [ABSTRACT FROM AUTHOR]