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. 2013 Jul-Aug;45(7):463-74.

Physician roles in the cancer-related follow-up care of cancer survivors

Carrie N Klabunde  1 , Paul K J Han, Craig C Earle, Tenbroeck Smith, John Z Ayanian, Richard Lee, Anita Ambs, Julia H Rowland, Arnold L Potosky
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Physician roles in the cancer-related follow-up care of cancer survivors

Carrie N Klabunde et al. Fam Med. 2013 Jul-Aug.

Abstract

Background and objectives: Information about primary care physicians' (PCPs) and oncologists' involvement in cancer-related follow-up care, and care coordination practices, is lacking but essential to improving cancer survivors' care. This study assesses PCPs' and oncologists' self-reported roles in providing cancer-related follow-up care for survivors who are within 5 years of completing cancer treatment.

Methods: In 2009, the National Cancer Institute and the American Cancer Society conducted a nationally representative survey of PCPs (n=1,014) and medical oncologists (n=1,125) (response rate=57.6%, cooperation rate=65.1%). Mailed questionnaires obtained information on physicians' roles in providing cancer-related follow-up care to early-stage breast and colon cancer survivors, personal and practice characteristics, beliefs about and preferences for follow-up care, and care coordination practices.

Results: More than 50% of PCPs reported providing cancer-related follow-up care for survivors, mainly by co-managing with an oncologist. In contrast, more than 70% of oncologists reported fulfilling these roles by providing the care themselves. In adjusted analyses, PCP co-management was associated with specialty, training in late or long-term effects of cancer, higher cancer patient volume, favorable attitudes about PCP care involvement, preference for a shared model of survivorship care, and receipt of treatment summaries from oncologists. Among oncologists, only preference for a shared care model was associated with co-management with PCPs.

Conclusions: PCPs and oncologists differ in their involvement in cancer-related follow-up care of survivors, with co-management more often reported by PCPs than by oncologists. Given anticipated national shortages of PCPs and oncologists, study results suggest that improved communication and coordination between these providers is needed to ensure optimal delivery of follow-up care to cancer survivors.

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Figures

Figure 1A
Figure 1A
Involvement of primary care physicians (PCPs) and medical oncologists in cancer-related follow-up care for breast cancer survivors
Figure 1B
Figure 1B
Involvement of primary care physicians (PCPs) and medical oncologists in cancer-related follow-up care for colon cancer survivors
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