title: Primary care for young adult cancer survivors: an international perspective.
abstract: OBJECTIVE
  Internationally, family physicians (FP) are not routinely involved in young adult cancer (YAC) care. In this short report, we would like to make a compelling argument for primary care involvement.
  
  
  METHODS
  Comparative descriptions and literature review.
  
  
  RESULTS
  Cancer among YAs is rare and usually not the first thing that comes into the FP's mind. Youth is sometimes mistakenly regarded as a protective factor. Across the countries, almost all YACs are treated in tertiary health care facilities with specialists providing the majority of care. Health care services are covered by the universal health insurance in Denmark, The Netherlands, and Canada but not in the US. Once the YAC has completed acute treatment and follow-up care, they often return to the care of the FPs who may potentially be expected to deal with and take action upon any possible medical, mental health, and psychosocial issues the YA cancer patient may present with. The role of the FP in follow-up care seems to be very limited.
  
  
  CONCLUSIONS
  YACs in the western world seem to have comparable medical and psychosocial problems. However, the nature of health insurance is such that it impacts differently on the care of this group of cancer patients. Primary care features such as patient-centered, integrated, and comprehensive care over extended periods of time bring the FP into the unique position to provide follow-up for YAC. However, this will require integrating patient's perspectives on their care, professional continuing medical education (CME) initiatives, and an enhanced cooperative effort between those delivering and coordinating cancer care.
authors.affiliation: Department of Public Health, University of Copenhagen, Øster Farimagsgade 5, Copenhagen, Denmark. bibihoe@sund.ku.dk
authors.forename: Bibi
authors.initials: B
authors.lastname: Hølge-Hazelton
authors.forename: Lyla
authors.initials: L
authors.lastname: Blake-Gumbs
authors.forename: Baujke
authors.initials: B
authors.lastname: Miedema
authors.forename: Eric
authors.initials: E
authors.lastname: van Rijswijk
mesh_terms: D019033:Delivery of Health Care, Integrated / Q000379:methods; D005194:Family Practice / Q000379:methods*; D006801:Humans; D009369:Neoplasms / Q000453:epidemiology / Q000628:therapy*; D018802:Patient-Centered Care / Q000379:methods; D010821:Physicians, Family / Q000458:organization & administration; D011320:Primary Health Care / Q000379:methods*; D017741:Survivors; D013997:Time Factors; D055815:Young Adult