Background: The growing number of cancer survivors combined with a looming shortage of oncology specialists will require greater coordination of post-treatment care responsibilities between oncologists and primary care physicians (PCPs). However, data are limited regarding these physicians' views of cancer survivors' care.
Objective: To compare PCPs and oncologists with regard to their knowledge, attitudes, and practices for follow-up care of breast and colon cancer survivors.
Design And Subjects: Mailed questionnaires were completed by a nationally representative sample of 1,072 PCPs and 1,130 medical oncologists in 2009 (cooperation rate = 65%). Sampling and non-response weights were used to calculate estimates to reflect practicing US PCPs and oncologists.
Main Measures: PCPs and oncologists reported their 1) preferred model for delivering cancer survivors' care; 2) assessment of PCPs' ability to perform follow-up care tasks; 3) confidence in their knowledge; and 4) cancer surveillance practices.
Key Results: Compared with PCPs, oncologists were less likely to believe PCPs had the skills to conduct appropriate testing for breast cancer recurrence (59% vs. 23%, P < 0.001) or to care for late effects of breast cancer (75% vs. 38%, P < 0.001). Only 40% of PCPs were very confident of their own knowledge of testing for recurrence. PCPs were more likely than oncologists to endorse routine use of non-recommended blood and imaging tests for detecting cancer recurrence, with both groups departing substantially from guideline recommendations.
Conclusion: There are significant differences in PCPs' and oncologists' knowledge, attitudes, and practices with respect to care of cancer survivors. Improving cancer survivors' care may require more effective communication between these two groups to increase PCPs' confidence in their knowledge, and must also address oncologists' attitudes regarding PCPs' ability to care for cancer survivors.
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http://dx.doi.org/10.1007/s11606-011-1808-4 | DOI Listing |
JCO Oncol Pract
December 2024
Department of Internal Medicine and Rogel Cancer Center, University of Michigan, Ann Arbor, MI.
Purpose: Very little is known about primary care involvement in the care of cancer survivors beyond the initial 5 years post-treatment when transitioning to primary care is guideline-recommended for many survivors.
Methods: The ICanCare study is a longitudinal survey of women diagnosed with breast cancer in 2014-2015 identified in the Georgia and Los Angeles SEER registries. Women were surveyed during initial treatment and again approximately 6 years later in survivorship (2021-2022; n = 1,412, 60% response rate).
JAMA Health Forum
August 2024
Department of Health Policy & Management, Harvard T.H. Chan School of Public Health, Boston, Massachusetts.
Importance: Vertical relationships (ownership, affiliations, joint contracting) between physicians and health systems are increasing in the US. Many proponents of vertical relationships argue that increased spending associated with consolidation is accompanied by improvements in quality of care.
Objective: To assess the association of vertical relationships between primary care physicians (PCPs) and large health systems and quality of care.
Cancer
November 2024
Memorial Sloan Kettering Cancer Center, New York, New York, USA.
Background: Older head and neck cancer (HNC) survivors have concerning rates of potentially unsafe opioid prescribing. Identifying the specialties of opioid prescribers for HNC survivors is critical for targeting the settings for opioid safety interventions. This study hypothesized that oncology and surgery providers are primarily responsible for opioid prescriptions in the year after treatment but that primary care providers (PCPs) are increasingly involved in prescribing over time.
View Article and Find Full Text PDFJCO Oncol Pract
May 2024
Department of Social Sciences and Health Policy, Wake Forest University School of Medicine, Winston-Salem, NC.
Purpose: Cancer survivors experience better outcomes when primary care providers (PCPs) are engaged in their care. Nearly all survivors have a PCP engaged in their care in the initial 5 years postdiagnosis, but little is known about sustained PCP engagement. We assessed PCP engagement in survivors' care 5-7 years postdiagnosis and characterized survivors most vulnerable to loss to PCP follow-up.
View Article and Find Full Text PDFJ Neurooncol
June 2024
Department of Neurosurgery, Johns Hopkins University School of Medicine, 1800 Orleans St, 21287, Baltimore, MD, USA.
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