title: Delivery of survivorship care by primary care physicians: the perspective of breast cancer patients.
abstract: OBJECTIVE
  Most of the 182,460 women diagnosed with breast cancer in the United States this year will become long-term survivors. Helping these women transition from active treatment to survivorship is a challenge that involves both oncologists and primary care physicians (PCPs). This study aims to describe postmenopausal breast cancer survivors' (BCS) perceptions of PCP-related survivorship care.
  
  
  METHODS
  We conducted a cross-sectional survey of 300 BCSs seen in an outpatient breast oncology clinic at a large university hospital. The primary outcome measure was a seven-item self-reported measure on perceived survivorship care (Cronbach's alpha = .89). Multivariate regression analyses were used to identify factors associated with perceived care delivery.
  
  
  RESULTS
  Overall, BCSs rated PCP-related survivorship care as 65 out of 100 (standard deviation = 17). The areas of PCP-related care most strongly endorsed were general care (78%), psychosocial support (73%), and health promotion (73%). Fewer BCSs perceived their PCPs as knowledgeable about cancer follow-up (50%), late effects of cancer therapies (59%), or treating symptoms related to cancer or cancer therapies (41%). Only 28% felt that their PCPs and oncologists communicated well. In a multivariate regression analysis, nonwhite race and level of trust in the PCP were significantly associated with higher perceived level of PCP-related survivorship care (P = .001 for both).
  
  
  CONCLUSIONS
  Although BCSs perceived high quality of general care provided by their PCPs, they were not as confident with their PCPs' ability to deliver cancer-specific survivorship care. Interventions need to be tested to improve oncology-primary care communication and PCP knowledge of cancer-specific survivorship care.
authors.affiliation: Department of Family Medicine and Community Health, Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania Health System, Philadelphia, PA 19104, USA. jun.mao@uphs.upenn.edu
authors.forename: Jun J
authors.initials: JJ
authors.lastname: Mao
authors.forename: Marjorie A
authors.initials: MA
authors.lastname: Bowman
authors.forename: Carrie T
authors.initials: CT
authors.lastname: Stricker
authors.forename: Angela
authors.initials: A
authors.lastname: DeMichele
authors.forename: Linda
authors.initials: L
authors.lastname: Jacobs
authors.forename: Dingyun
authors.initials: D
authors.lastname: Chan
authors.forename: Katrina
authors.initials: K
authors.lastname: Armstrong
mesh_terms: D000368:Aged; D001294:Attitude to Health; D001943:Breast Neoplasms / Q000523:psychology* / Q000628:therapy*; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008875:Middle Aged; D017698:Postmenopause; D011320:Primary Health Care; D017741:Survivors / Q000523:psychology*