How have Patients' Experiences of Cancer Care Been Linked to Survival? A Systematic Review

Patient experience of care remains an important indicator of health care quality. Although studies show care experiences are associated with health outcomes for some conditions, the situation for cancer is unclear. New datasets on cancer patients in the US, Canada, and UK linking information on experiences and survival may enable an exploration of any association. This review aimed to identify studies linking any aspect of cancer patients’ experiences to their survival, to inform future analyses. We performed a systematic review using Medline database from January 1998 until March 2018. The settings included outpatient oncology clinics, primary care, hospitals, and cancer centres. The participants included adult patients from different demographic groups. 16 Studies (ten observational, two clinical trials, two qualitative, and two consecutive case series) describing a wide range of settings, populations and methods met our inclusion criteria. Patients’ experiences were mostly linked to survival in quantitative studies. Satisfaction with care and psychosocial support were the aspects of experience associated with survival. Although positive associations between experience and survival were more common, negative and lack of association findings were also reported. Overall, there was no agreement on the strength, direction of the association, and the type of measurements to use. In conclusion, a wide range of studies suggest a relationship may exist between patients’ experiences of cancer care and their survival. However, this relationship is complex and methodological challenging to study. Future research should carefully consider different aspects of patient experience and care and the way in which they may affect cancer survival