title: Follow-up care for cancer survivors: the views of clinicians.
abstract: BACKGROUND
  Evidence for the efficacy of late effects surveillance in adult cancer survivors is lacking and there is little agreement among clinicians on appropriate follow-up care.
  
  
  METHODS
  We report the views of both cancer experts and general practitioners (GPs) on long-term follow-up provision for cancer survivors, focussing on the 18-45 years age group. A total of 421 cancer experts (36% haematologists, 33% oncologists, 18% surgeons, 10% nurses, 2% other) and 54 GPs responded to a structured online survey. Reasons for follow-up care (clinical or supportive); advantages and disadvantages of follow-up in primary care; current practice; and resources required for a quality follow-up service were assessed.
  
  
  RESULTS
  Clinicians valued clinical reasons for follow-up more highly than supportive reasons (P<0.001). Learning more about late effects and checking for cancer recurrence were rated as the most important reasons for follow-up by cancer experts and GPs. A total of 85% of cancer specialists hold follow-up consultations alongside patients on active treatment. Cancer experts agreed that primary care follow-up would increase their availability for acute oncological care, but reduce information on late effects. The most important resource to provide a quality follow-up service was specialist nursing support (91%).
  
  
  CONCLUSIONS
  Follow-up guidelines that include late effects surveillance are needed. Where and who should deliver this care requires further debate.
authors.affiliation: Academic Unit of Clinical Oncology, Weston Park Hospital, WhithamRoad, Sheffield S10 2SJ, UK. d.greenfield@sheffield.ac.uk
authors.forename: D M
authors.initials: DM
authors.lastname: Greenfield
authors.forename: K
authors.initials: K
authors.lastname: Absolom
authors.forename: C
authors.initials: C
authors.lastname: Eiser
authors.forename: S J
authors.initials: SJ
authors.lastname: Walters
authors.forename: G
authors.initials: G
authors.lastname: Michel
authors.forename: B W
authors.initials: BW
authors.lastname: Hancock
authors.forename: J A
authors.initials: JA
authors.lastname: Snowden
authors.forename: R E
authors.initials: RE
authors.lastname: Coleman
mesh_terms: D000293:Adolescent; D000328:Adult; D003266:Continuity of Patient Care; D003695:Delivery of Health Care / Q000379:methods; D017408:Guidelines as Topic; D006801:Humans; D008495:Medical Oncology; D008875:Middle Aged; D009369:Neoplasms / Q000523:psychology / Q000628:therapy*; D010820:Physicians; D010821:Physicians, Family; D011364:Professional Practice; D011795:Surveys and Questionnaires; D017741:Survivors / Q000523:psychology; D055815:Young Adult