title: Caring for cancer survivors: a survey of primary care physicians.
abstract: BACKGROUND
  The number of long-term US cancer survivors is expected to double by the year 2050. Although primary care physicians (PCPs) provide the majority of care for long-term cancer survivors, to the authors' knowledge, few data to date have detailed PCP practice patterns, attitudes, and challenges in caring for long-term cancer survivors.
  
  
  METHODS
  Self-administered surveys were mailed to 406 community- and academic-based general internal medicine physicians in Denver, Colorado. Survey development included in-depth physician interviews and pretesting. Of the 299 responses, 72 were ineligible; an analysis of the data from 227 surveys is presented.
  
  
  RESULTS
  The response rate was 76%. Community-based PCPs comprised 70% of completed surveys. Reported care patterns were assessed to create a multidimensional care score reflecting levels of attention to 4 areas of survivorship care: monitoring for cancer recurrence, management of late effects, sexual functioning, and mental health. Only 24% of PCPs met criteria for routinely providing more multidimensional survivorship care. More recent medical school graduates reported providing less multidimensional survivorship care when compared with their more experienced colleagues. Approximately 82% of PCPs believed that primary care guidelines for adult cancer survivors are not well defined, and 47% of PCPs cited inadequate preparation and lack of formal training in cancer survivorship as a problem when delivering care to long-term survivors.
  
  
  CONCLUSIONS
  Although PCPs provide the bulk of care for long-term survivors within the survivorship phase of the cancer trajectory, only a small subset have reported providing multidimensional survivorship care. Results underscore a need for substantially increased training in survivorship care to support the delivery of multidimensional primary care for long-term survivors.
authors.affiliation: Department of Pediatric Oncology, Dana-Farber Cancer Institute, Harvard Medical School, and Institute for Health Policy, Massachusetts General Hospital, Boston, Massachusetts 02115, USA. sharon_bober@dfci.harvard.edu
authors.forename: Sharon L
authors.initials: SL
authors.lastname: Bober
authors.forename: Christopher J
authors.initials: CJ
authors.lastname: Recklitis
authors.forename: Eric G
authors.initials: EG
authors.lastname: Campbell
authors.forename: Elyse R
authors.initials: ER
authors.lastname: Park
authors.forename: Jean S
authors.initials: JS
authors.lastname: Kutner
authors.forename: Julie S
authors.initials: JS
authors.lastname: Najita
authors.forename: Lisa
authors.initials: L
authors.lastname: Diller
mesh_terms: D000328:Adult; D001291:Attitude of Health Personnel; D003695:Delivery of Health Care; D006801:Humans; D008134:Long-Term Care; D009369:Neoplasms / Q000628:therapy*; D010821:Physicians, Family / Q000193:education; D017410:Practice Guidelines as Topic; D011364:Professional Practice; D011787:Quality of Health Care; D017741:Survivors