title: Provider perspectives on presenting risk information and managing worry about recurrence among breast cancer survivors.
abstract: BACKGROUND
  Although worry about recurrence is a persistent concern among breast cancer survivors, little is known about physicians' confidence about presenting recurrence risk information, identifying women with considerable worry, and helping women manage worry.
  
  
  METHODS
  Between January and June 2012, we surveyed 750 surgeons and 750 medical oncologists randomly sampled from the American Medical Association Physician Masterfile. We tested differences between surgeons and medical oncologists on confidence of presenting risk, identifying and managing worry using chi-square statistic and Student's t-tests and developed multiple variable logistic regression models to explain odds regarding confidence and use of different strategies for managing worry.
  
  
  RESULTS
  The analytic sample included 403 surgeons and 363 medical oncologists (n = 766; response rate = 60%). Compared with surgeons, medical oncologists were significantly more likely to report confidence in: presenting risk information (87.5% vs 73.2%), identifying women who are worried (74.1% vs 63.9%), and managing worry (66.9% vs 52.4%). Confidence in managing worry was associated with more regular inquiry about worry (p = 0.009). Models of the likelihood of using different management strategies varied by provider type (e.g., surgeons more likely than medical oncologists to recommend support group or online resources, oncologists more likely to refer to psychologist or use medications, all p < 0.05).
  
  
  CONCLUSIONS
  Cancer providers, particularly surgeons, may benefit from educational training to raise confidence in identifying women with high levels of worry and managing women with considerable worry. Communication between specialties and primary care physicians on efforts to manage worry is necessary for coordinated, quality care for women with breast cancer.
authors: Department of Health Behavior and Health Education, School of Public Health, University of Michigan, Ann Arbor, MI, USA.
authors: Nancy K
authors: NK
authors: Janz
authors: Rebecca L
authors: RL
authors: Leinberger
authors: Brian J
authors: BJ
authors: Zikmund-Fisher
authors: Sarah T
authors: ST
authors: Hawley
authors: Kent
authors: K
authors: Griffith
authors: Reshma
authors: R
authors: Jagsi
mesh_terms: D000328:Adult; D000368:Aged; D001007:Anxiety / Q000523:psychology / Q000628:therapy*; D001291:Attitude of Health Personnel; D001943:Breast Neoplasms / Q000523:psychology*; D003142:Communication; D030881:Disclosure; D019468:Disease Management; D005260:Female; D006801:Humans; D008297:Male; D008495:Medical Oncology; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000523:psychology*; D010817:Physician-Patient Relations; D012306:Risk; D066231:Surgeons; D017741:Survivors / Q000523:psychology*
keywords: Breast Cancer; Cancer; Oncology; Survivorship; Worry about recurrence