Colorectal Cancer Survivorship Care in Thailand

As greater attention is given to cancer survivorship care globally, disparities in colorectal cancer (CRC) survivorship care have been identified in low- and middle-income countries (LMIC). CRC survivors face long-term challenges after treatment completion, yet their needs are inadequately addressed. International efforts have been made to develop and improve services for cancer survivors. However, there is limited evidence on appropriate survivorship care services, especially in LMICs. In Thailand, survivorship care is integrated into existing traditional care services. However, whether this approach achieves quality survivorship care, addresses CRC survivors’ needs, or optimizes their long-term outcomes is uncertain. There is minimal literature to describe the CRC survivorship care phenomenon in Thailand. This dissertation research study aimed to gain an in-depth understanding of survivorship care in Thailand based on the experiences and perspectives of two streak holders: (1) healthcare providers (HCPs) and (2) CRC survivors. The specific aims of the first study were to explore organizational-level facilitators and barriers to CRC survivorship care and recommendations for improvements based on the perspectives of HCPs. The study results identified facilitators and barriers to CRC survivorship care related to hospital leadership, information systems, care delivery, staff support, and resources. Moreover, the study results provided recommendations regarding models of CRC survivorship care, treatment summary, checklist, survivorship care plan, and national information systems. The second study explored CRC survivors’ perspectives regarding CRC survivorship care. Study findings presented important descriptions regarding current care received, survivor unmet needs, barriers, and facilitators for accessing care, and care preferences. Overall, study findings of this dissertation study have important implications for the future development and implementation of survivorship care services and offer guidance for prioritizing capacity building for CRC survivorship care in Thailand.