Primary Care Provider Involvement in Thyroid Cancer Survivorship Care

J Clin Endocrinol Metab. 2020 Sep 1;105(9):e3300-e3306. doi: 10.1210/clinem/dgaa437.


Context: While prior research has examined how primary care providers (PCPs) can care for breast and colon cancer survivors, little is known about their role in thyroid cancer survivorship.

Objective: To understand PCP involvement and confidence in thyroid cancer survivorship care.

Design/setting/participants: We surveyed PCPs identified by thyroid cancer patients from the Georgia and LA SEER registries (n = 162, response rate 56%). PCPs reported their involvement in long-term surveillance and confidence in handling survivorship care (role of random thyroglobulin levels and neck ultrasound, and when to end long-term surveillance and refer back to the specialist). We examined: 1) PCP-reported factors associated with involvement using multivariable analyses; and 2) bivariate associations between involvement and confidence in handling survivorship care.

Main outcome measures: PCP involvement (involved vs not involved) and confidence (high vs low).

Results: Many PCPs (76%) reported being involved in long-term surveillance. Involvement was greater among PCPs who noted clinical guidelines as the most influential source in guiding treatment (OR 4.29; 95% CI, 1.56-11.82). PCPs reporting high confidence in handling survivorship varied by aspects of care: refer patient to specialist (39%), role of neck ultrasound (36%) and random thyroglobulin levels (27%), and end long-term surveillance (14%). PCPs reporting involvement were more likely to report high confidence in discussing the role of random thyroglobulin levels (33.3% vs 7.9% not involved; P < 0.01).

Conclusions: While PCPs reported being involved in long-term surveillance, gaps remain in their confidence in handling survivorship care. Thyroid cancer survivorship guidelines that delineate PCP roles present one opportunity to increase confidence about their participation.

Keywords: primary health care; survivorship; thyroid neoplasms.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adult
  • Attitude of Health Personnel
  • Cancer Survivors* / statistics & numerical data
  • Female
  • Georgia / epidemiology
  • Humans
  • Los Angeles / epidemiology
  • Male
  • Middle Aged
  • Monitoring, Physiologic / standards
  • Monitoring, Physiologic / statistics & numerical data
  • Physician's Role
  • Physicians, Primary Care / standards
  • Physicians, Primary Care / statistics & numerical data*
  • Practice Patterns, Physicians' / standards
  • Practice Patterns, Physicians' / statistics & numerical data*
  • Primary Health Care / methods
  • Primary Health Care / standards
  • Primary Health Care / statistics & numerical data
  • Registries
  • SEER Program
  • Survivorship*
  • Thyroid Neoplasms / epidemiology
  • Thyroid Neoplasms / rehabilitation*