Long-term cancer survivor awareness and learning preferences for cardio- oncologic risks: A qualitative study

Purpose: To understand general CVD risk awareness and learning preferences of cancer survivors, with particular attention to the learning needs of long-term (>5 year) survivors. Methods: We performed a qualitative sub-study of participants recruited from 14 community educational and health events in an underserved are of Dallas, TX from July 2023 – May 2024. Recorded interviews were transcribed verbatim, analyzed in two phases (framework analysis then systematic coding) to identify themes. Results: Twenty-six cancer survivors ranging in age from 30 to 82 (average age of 64.5 years) were interviewed, a large majority being long-term (>5 year) survivors and African American. Participants had diverse types of cancer, predominantly breast or prostate. Triangulation methods produced 3 themes: (1) Although a majority (73%) of participants self-reported knowledge about CVD risks after cancer treatment, narratives revealed a substantial lack of clarity about individual cardio-oncologic risk factors, such as the latent risks from chemotherapy or radiation. (2) Participants expressed trust and satisfaction with communications from their cancer treatment team with most (77%) stating that greater CVD risk understanding would not have changed their oncology treatment decisions. (3) For learning about CVD risks, participants preferred conversations with healthcare providers at multiple time points, before and after oncology treatment, as well as written materials that could be preserved and consulted later in the survivorship period. Conclusion: Survivors initially over-estimated their knowledge of CVD risks related to their cancer treatment and relied on their clinicians to raise concerns. Survivors’ awareness of CVD risks may be improved through targeted communications by clinicians, particular for long-term survivors, supplemented by durable reference materials. Greater attention to long-term CVD risk awareness in cancer survivors may improve CVD prevention among cancer survivors.