Unmet needs in cancer rehabilitation during the early cancer trajectory – a nationwide patient survey

Figures & data

Table I. Patient characteristics (n = 4346).

	n	%
Sex (n = 4346)
Women	2208	50.8
Men	2138	49.2
Age (years) (n = 4346)
18–39	132	3.0
40–49	302	6.9
50–59	767	17.6
60–69	1520	35.0
70–79	1099	25.3
801	526	12.1
Cancer type (n = 4346)
Breast	982	22.6
Gastrointestinal	815	18.8
Prostate	720	16.6
Lung	363	8.4
Lymphoma and blood	280	6.4
Melanoma	238	5.5
Gynaecological	231	5.3
Urinary tract	204	4.7
Head and neck	195	4.5
Other	318	7.3
Treatment
Chemotherapy (n = 3936)	1603	40.7
Radiotherapy (n = 3838)	1125	29.3
Surgery (n = 4034)	2865	71.0
Educational level (n = 3983)
< 10 years	1061	26.6
10–12 years	2181	54.8
> 12 years	741	18.6
Cohabitation status (n = 4124)
Married/living together	3043	73.8
Widow/widower	498	12.1
Single	583	14.1
Children
Living at home (n = 2423)	564	23.3
Living away from home (n = 3871)	3327	85.9

Table II. Frequency of different unmet needs, by sex, age and cancer type during early cancer trajectory. Absolute numbers (n/N) and percentages are shown, the latter with 95% confidence intervals (CI) in parentheses.

	Counselling with a psychologist		Counselling related to work life/education		Physical rehabilitation		Practical help		Talking to other patients in the same situation
	n/N	% (95% CI)	n/N	% (95% CI)	n/N	% (95% CI)	n/N	% (95% CI)	n/N	% (95% CI)
All	806/3771	21.4 (20.1–22.7)	561/3785	14.8 (13.7–16.0)	320/1702	18.8 (16.9–20.7)	668/3852	17.3 (16.1–18.5)	918/3808	24.1 (22.7–25.5)
Sex (n = 4346)
Women	447/1933	23.1 (21.2–25.0)	323/1942	16.6 (15.0–18.3)	184/943	19.5 (17.0–22.0)	389/1984	19.6 (17.9–21.4)	506/1958	25.8 (23.9–27.8)
Men	359/1838	19.5 (17.7–21.3)	238/1843	12.9 (11.4–14.4)	136/759	17.9 (15.2–20.7)	279/1868	14.9 (13.3–16.6)	412/1850	22.3 (20.4–24.2)
Age (years) (n = 4346)
18–39	57/122	46.7 (37.8–55.6)	51/124	41.1 (32.4–49.8)	9/64	14.1 (5.5–2.22)	24/128	18.8 (12.0–25.5)	56/122	45.9 (37.0–54.8)
40–49	87/268	32.5 (26.8–38.1)	87/281	30.9 (25.5–36.4)	25/108	23.1 (15.2–31.1)	36/280	12.9 (8.9–16.8)	109/278	39.2 (33.4–45.0)
50–59	183/718	25.5 (22.3–28.7)	208/727	28.6 (25.3–31.9)	86/296	29.1 (23.9–34.2)	131/732	17.9 (15.1–20.7)	241/725	33.2 (29.8–36.7)
60–69	242/1370	17.7 (15.6–19.7)	140/1376	10.2 (8.6–11.8)	110/616	17.9 (14.8–20.9)	188/1382	13.6 (11.8–15.4)	285/1364	20.9 (18.7–23.1)
70–79	166/915	18.1 (15.6–20.6)	50/907	5.5 (4.0–7.0)	56/399	14.0 (10.6–17.5)	178/938	19.0 (16.5–21.5)	164/929	17.7 (15.2–20.1)
801	71/378	18.8 (14.8–22.7)	25/370	6.8 (4.2–9.3)	34/219	15.5 (10.7–20.3)	111/392	28.3 (23.8–32.8)	63/390	16.2 (12.5–19.8)
Cancer type (n = 4346)
Breast	150/868	17.3 (14.8–19.8)	140/866	16.2 (13.7–18.6)	94/428	22.0 (18.0–25.9)	129/883	14.6 (12.3–16.9)	208/883	23.6 (20.8–26.4)
Gastrointestinal	150/702	21.4 (18.3–24.4)	95/706	13.5 (10.9–16.0)	40/270	14.8 (10.6–19.1)	156/728	21.4 (18.4–24.4)	160/710	22.5 (19.5–25.6)
Prostate	93/597	15.6 (12.7–18.5)	66/597	11.1 (8.5–13.6)	46/210	21.9 (16.3–27.5)	80/597	13.4 (10.7–16.1)	127/602	21.1 (17.8–24.4)
Lung	90/325	27.7 (22.8–32.6)	46/322	14.3 (10.4–18.1)	24/110	21.8 (14.1–29.6)	77/328	23.5 (18.9–28.1)	76/320	23.8 (19.1–28.4)
Lymphoma and blood	54/242	22.3 (17.1–27.6)	40/240	16.7 (11.9–21.4)	16/76	21.1 (11.8–30.3)	32/243	13.2 (8.9–17.4)	63/245	25.7 (20.2–31.2)
Melanoma	38/214	17.8 (12.6–22.9)	25/220	11.4 (7.2–15.6)	16/176	9.1 (4.8–13.4)	16/217	7.4 (3.9–10.9)	37/215	17.2 (12.2–22.3)
Gynaecological	51/202	25.3 (19.2–31.3)	38/206	18.5 (13.1–23.8)	21/126	16.7 (10.1–23.2)	43/209	20.6 (15.1–26.1)	54/207	26.1 (20.1–32.1)
Urinary tract	47/175	26.9 (20.3–33.4)	28/172	16.3 (10.7–21.8)	18/87	20.7 (12.1–29.3)	41/179	22.9 (16.7–29.1)	50/173	28.9 (22.1–35.7)
Head and neck	52/171	30.4 (23.5–37.3)	30/175	17.1 (11.5–22.7)	23/87	26.4 (17.1–35.8)	37/180	20.6 (14.6–26.4)	56/174	32.2 (25.2–39.1)
Other	81/275	29.5 (24.1–34.9)	53/281	18.9 (14.3–23.4)	22/132	16.7 (10.3–23.1)	57/288	19.8 (15.2–24.4)	87/279	31.2 (25.7–36.6)

Table III. Patients' perception of unmet needs of rehabilitation. For each type of rehabilitation adjusted odds ratios (OR) are shown with regard to sociodemographic and clinical characteristics. 95% confidence intervals (CI) in parentheses.

	Counselling with a psychologist	Counselling related to work life/education		Physical rehabilitation	Practical help			Talking to other patients
	AllOR^c (95% CI)	Women^a OR^d (95% CI)	Men^a OR^d (95% CI)	All OR^c (95% CI)	<10 years of education^b OR^e (95% CI)	10–12 years of education^b OR^e (95% CI)	>12 years of education^b OR^e (95% CI)	All OR^c (95% CI)
Sex
Women	1.00	1.00^f	1.00^f	1.00	1.00	1.00	1.00	1.00
Men	1.45 (1.16–1.80)	1.12 (0.86–1.46)	1.12 (0.86–1.46)	1.24 (0.85–1.80)	2.30 (1.51–3.50)	1.58 (1.12–2.23)	1.21 (0.62–2.34)	1.31 (1.06–1.64)
Age (years)
1. quartile (youngest)	1.00	1.00	1.00	1.00	1.00	1.00	1.00	1.00
2. quartile	0.51 (0.40–0.63)	0.26 (0.19–0.37)	0.34 (0.23–0.51)	0.57 (0.40–0.81)	0.78 (0.45–1.35)	0.62 (0.44–0.88)	0.83 (0.44–1.54)	0.43 (0.35–0.53)
3. quartile	0.45 (0.36–0.57)	0.11 (0.07–0.19)	0.14 (0.09–0.22)	0.66 (0.46–0.95)	0.84 (0.50–1.42)	0.70 (0.48–1.01)	0.61 (0.31–1.24)	0.38 (0.30–0.47)
4. quartile (oldest)	0.40 (0.30–0.53)	0.06 (0.03–0.12)	0.20 (0.13–0.32)	0.38 (0.24–0.59)	1.60 (0.95–2.71)	0.91 (0.60–1.39)	1.06 (0.50–2.24)	0.28 (0.21–0.37)
Cancer type
Breast	1.00	1.00	1.42 (0.14–14.75)	1.00	1.00	1.00	1.00	1.00
Gastrointestinal	1.81 (1.36–2.43)	1.12 (0.74–1.71)	0.99 (0.65–1.52)	0.76 (0.47–1.22)	2.19 (1.29–3.72)	1.81 (1.19–2.76)	2.05 (0.94–4.48)	1.37 (1.04–1.81)
Prostate	1.80 (1.24–2.61)	–	1.00	1.38 (0.79–2.40)	2.65 (1.30–5.41)	1.48 (0.84–2.62)	1.23 (0.45–3.37)	1.66 (1.17–2.35)
Lung	2.50 (1.77–3.51)	1.73 (1.02–2.94)	0.68 (0.38–1.24)	1.34 (0.76–2.36)	2.00 (1.07–3.74)	2.10 (1.26–3.50)	2.20 (0.79–6.12)	1.35 (0.95–1.90)
Lymphoma and blood	1.97 (1.34–2.89)	2.19 (1.26–3.79)	0.63 (0.33–1.20)	0.82 (0.41–1.65)	2.89 (1.37–6.09)	0.65 (0.30–1.37)	0.90 (0.28–2.92)	1.48 (1.03–2.14)
Melanoma	1.20 (0.79–1.81)	0.52 (0.29–0.93)	0.48 (0.23–1.02)	0.29 (0.16–0.53)	1.17 (0.41–3.38)	0.72 (0.36–1.44)	–	0.71 (0.47–1.07)
Gynaecological	1.65 (1.13–2.42)	1.40 (0.91–2.16)	–	0.70 (0.41–1.21)	1.66 (0.83–3.32)	1.10 (0.61–1.97)	2.30 (0.81–6.58)	1.23 (0.85–1.78)
Urinary tract	2.87 (1.85–4.45)	1.92 (0.65–5.62)	1.18 (0.67–2.08)	1.05 (0.54–2.04)	4.38 (1.96–9.79)	1.29 (0.61–2.71)	4.04 (1.34–12.24)	2.25 (1.47–3.43)
Head and neck	2.83 (1.86–4.28)	1.10 (0.53–2.29)	0.78 (0.41–1.47)	1.27 (0.69–2.34)	2.16 (0.89–5.21)	2.27 (1.22–4.22)	1.14 (0.34–3.83)	1.99 (1.33–2.99)
Other	2.55 (1.79–3.62)	1.20 (0.68–2.11)	0.87 (0.52–1.47)	0.70 (0.39–1.27)	3.37 (1.68–6.74)	1.45 (0.84–2.49)	1.66 (0.60–4.65)	1.64 (1.17–2.31)
Education
< 10 years	1.00	1.00	1.00	1.00	1.00^g	1.00^g	1.00^g	1.00
10–12 years	0.70 (0.58–0.86)	0.82 (0.57–1.17)	0.77 (0.53–1.11)	1.34 (0.96–1.88)	0.60 (0.49–0.73)	0.60 (0.49–0.73)	0.60 (0.49–0.73)	0.80 (0.66–0.97)
> 12 years	0.67 (0.52–0.87)	0.88 (0.57–1.36)	0.92 (0.59–1.42)	2.06 (1.39–3.06)	0.53 (0.40–0.70)	0.53 (0.40–0.70)	0.53 (0.40–0.70)	0.71 (0.56–0.91)
Cohabitation status
Married/living together	1.00	1.00	1.00	1.00	1.00	1.00	1.00	1.00
Widow/widower	1.23 (0.93–1.64)	0.89 (0.50–1.60)	1.29 (0.69–2.44)	1.19 (0.76–1.85)	0.82 (0.52–1.31)	3.30 (2.26–4.82)	1.31 (0.55–3.09)	0.97 (0.72–1.30)
Single	1.39 (1.11–1.74)	1.01 (0.72–1.42)	2.02 (1.37–2.98)	1.43 (1.01–2.02)	1.74 (1.12–2.70)	1.80 (1.28–2.53)	1.77 (0.97–3.22)	1.50 (1.21–1.85)
Children
Living at home
No	1.00	1.00	1.00	1.00	1.00	1.00	1.00	1.00
Yes	1.64 (1.22–2.20)	1.09 (0.75–1.58)	1.09 (0.66–1.82)	1.39 (0.86–2.24)	1.64 (0.76–3.55)	0.67 (0.42–1.07)	1.44 (0.66–3.15)	1.32 (1.00–1.73)
Living away from home
No	1.00	1.00	1.00	1.00	1.00	1.00	1.00	1.00
Yes	1.03 (0.79–1.32)	0.83 (0.59–1.17)	1.14 (0.73–1.77)	0.80 (0.55–1.17)	1.17 (0.68–2.03)	1.04 (0.70–1.52)	0.71 (0.35–1.42)	1.09 (0.86–1.38)
Treatment
Chemotherapy
No	1.00	1.00	1.00	1.00	1.00	1.00	1.00	1.00
Yes	1.16 (0.95–1.42)	1.21 (0.89–1.65)	1.20 (0.81–1.78)	1.75 (1.22–2.50)	1.17 (0.79–1.71)	1.10 (0.80–1.50)	1.05 (0.60–1.83)	1.31 (1.08–1.59)
Radiotherapy
No	1.00	1.00	1.00	1.00	1.00	1.00	1.00	1.00
Yes	0.83 (0.68–1.03)	0.77 (0.56–1.06)	1.04 (0.71–1.52)	0.98 (0.70–1.38)	1.03 (0.69–1.54)	0.86 (0.62–1.19)	0.55 (0.29–1.02)	0.88 (0.72–1.07)
Surgery
No	1.00	1.00	1.00	1.00	1.00	1.00	1.00	1.00
Yes	0.96 (0.78–1.18)	1.00 (0.67–1.49)	1.02 (0.72–1.45)	1.15 (0.76–1.75)	0.81 (0.54–1.20)	1.28 (0.92–1.80)	1.79 (0.96–3.35)	1.09 (0.89–1.35)

^aStratified on sex; ^bStratified on educational level; ^cAdjusted for sex, age (quartiles), cancer type, education, and cohabitation status; ^dAdjusted for age (quartiles), cancer type, education, and cohabitation status; ^eAdjusted for sex, age (quartiles), cancer type, and cohabitation status; ^fNon-stratified analysis adjusted for age (quartiles), cancer type, and education; ^gNon-stratified analysis adjusted for sex, age (quartiles), and cancer type.