Cluster Analysis To Demonstrate The Need To Individualize Care For Cancer Survivors

Background. In efforts to inform clinical screening and development of survivorship care services, we sought to characterize patterns of health care needs among cancer survivors by (a) identifying and characterizing subgroups based on self-reported health care needs and (b) assessing sociodemographic, clinical, and psychosocial factors associated with these subgroups. Methods. We conducted a cross-sectional self-administered survey among patients presenting for routine follow-up care for early-stage cancer at our academic medical center. Latent class cluster analysis was used to identify clusters of survivors based on survivorship care needs within seven domains. Multiple logistic regression analyses were used to assess factors associated with these clusters. Results. Among 292 respondents, the highest unmet needs were related to the domains of side effects (53%), self-care (51%), and emotional coping (43%). Our analysis identified four clusters of survivors: (a) low needs (n=123, 42%), (b) mainly physical needs (n=46, 16%), (c) mainly psychological needs (n=57, 20%), and (d) both physical and psychological needs (n=66, 23%). Compared with cluster 1, those in clusters 2, 3, and 4 were younger (p<.03), those in clusters 3 and 4 had higher levels of psychological distress (p<.05), and those in clusters 2 and 4 reported higher levels of fatigue (p<.05). Conclusion. Unmet needs among cancer survivors are prevalent; however, a substantial group of survivors report low or no health care needs. The wide variation in health care needs among cancer survivors suggests a need to screen all patients, followed by tailored interventions in clinical care delivery and research.