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Differences between nurse practitioner and physician care providers on rates of secondary cancer screening and discussion of lifestyle changes among breast cancer survivors

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Abstract

Purpose

Breast cancer survivorship care is provided by surgical and medical oncologists, primary care physicians (PCPs), and nurse practitioner survivorship specialists (NPs). The study objective was to identify whether frequency of cancer screening and discussion of healthy lifestyles differed across these provider types. We also determined differences by provider in survivor reported follow through with lifestyle recommendations.

Methods

Breast cancer survivors completed surveys regarding the type of health-care provider they most recently saw, cancer screening, discussion, and self-reported lifestyle change since their breast cancer diagnosis.

Results

Seven hundred fifty-nine breast cancer survivors (78.7 % of those invited) completed the survey; 51.8 % indicated that their last visit was with a medical oncologist. There was no difference in rates of cancer screening (colon, cervical, and breast) among types of providers. A significantly larger proportion of patients who last saw an NP reported that they had discussed physical activity (78.6 %) as compared to medical oncologist 54.4 %, surgeon 43.1 %, radiation oncologist 64.1 %, and PCP 61.3 % (p < 0.001). Similar observations were observed for discussion of nutrition and weight (NP 70.0 %, medical oncologist 36.5 %, surgeon 25.7 %, radiation oncologist 48.7 %, PCP 35.5 %; p < 0.001). There was no significant difference across provider type in self-reported implementation of change in physical activity or diet.

Conclusions

Our data indicate that a visit to the NP was related to comparable screening rates, but despite that NPs are more often discussing lifestyle modification, self-reported change in nutrition and physical exercise did not differ across provider type.

Implications for Cancer Survivors

NPs perform favorably with respect to lifestyle recommendations. Given the reported lack of lifestyle change, it is important to triage to providers who specialize in lifestyle modification and, if plausible, learn and provide actual evidence-based approaches to achieve positive outcomes in this area.

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Conflict of interest

The authors declare that they have no conflict of interest.

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Authors and Affiliations

  1. Departments of Family Medicine and Community Health, Case Western Reserve University, 10900 Euclid Ave., Cleveland, OH, 44106, USA

    Tiffany C. Kenison & Cheryl L. Thompson

  2. Departments of Medicine, Case Western Reserve University, Cleveland, OH, 44106, USA

    Paula Silverman

  3. Departments of Epidemiology and Biostatistics, Case Western Reserve University, Cleveland, OH, 44106, USA

    Cheryl L. Thompson

  4. Case Comprehensive Cancer Center, Case Western Reserve University, Cleveland, OH, 44106, USA

    Paula Silverman & Cheryl L. Thompson

  5. University Hospitals Seidman Cancer Center, Cleveland, OH, 44106, USA

    Paula Silverman & Marla Sustin

Authors
  1. Tiffany C. Kenison
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  2. Paula Silverman
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  3. Marla Sustin
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  4. Cheryl L. Thompson
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Corresponding author

Correspondence to Cheryl L. Thompson.

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Kenison, T.C., Silverman, P., Sustin, M. et al. Differences between nurse practitioner and physician care providers on rates of secondary cancer screening and discussion of lifestyle changes among breast cancer survivors. J Cancer Surviv 9, 223–229 (2015). https://doi.org/10.1007/s11764-014-0405-z

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  • DOI: https://doi.org/10.1007/s11764-014-0405-z

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