title: Cancer survivorship practices, services, and delivery: a report from the Children's Oncology Group (COG) nursing discipline, adolescent/young adult, and late effects committees.
abstract: OBJECTIVE
  To describe survivorship services provided by the Children's Oncology Group (COG), an assessment of services was undertaken. Our overall aims were (1) to describe survivorship services, including the extent of services provided, resources (personnel, philanthropy, and research funding), billing practices, and barriers to care and 2) to describe models of care that are in use for childhood cancer survivors and adult survivors of childhood cancer.
  
  
  METHODS
  One hundred seventy-nine of 220 COG institutions (81%) completed an Internet survey in 2007.
  
  
  RESULTS
  One hundred fifty-five (87%) reported providing survivorship care. Fifty-nine percent of institutions provide care for their pediatric population in specialized late effects programs. For adult survivors, 47% of institutions chose models of care, which included transitioning to adult providers for risk-based health care, while 44% of institutions keep survivors indefinitely at the treating institution (Cancer Center Based Model without Community Referral). Sixty-eight percent provide survivors with a copy of their survivorship care plan. Only 31% of institutions provide a detailed summary of results after each clinic visit, and 41% have a database to track survivor health outcomes. Minimal time required for initial and annual survivorship visits is estimated to be approximately 120 and 90 min, respectively. The most prevalent barriers to care were the lack of dedicated time for program development and a perceived insufficient knowledge on the part of the clinician receiving the transition referral.
  
  
  CONCLUSIONS
  Not all COG institutions provide dedicated survivorship care, care plans, or have databases for tracking outcomes. Transitioning to adult providers is occurring within the COG. Survivorship care is time intensive.
authors: Division of Hematology-Oncology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH 45229-3039, USA. Debra.kent@cchmc.org
authors: Debra
authors: D
authors: Eshelman-Kent
authors: Karen E
authors: KE
authors: Kinahan
authors: Wendy
authors: W
authors: Hobbie
authors: Wendy
authors: W
authors: Landier
authors: Steve
authors: S
authors: Teal
authors: Debra
authors: D
authors: Friedman
authors: Rajaram
authors: R
authors: Nagarajan
authors: David R
authors: DR
authors: Freyer
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D003695:Delivery of Health Care; D006801:Humans; D008134:Long-Term Care; D009369:Neoplasms / Q000175:diagnosis / Q000401:mortality / Q000628:therapy*; D009732:Nursing Care; D016522:Oncology Service, Hospital / Q000458:organization & administration; D011364:Professional Practice / Q000639:trends*; D015996:Survival Rate; D017741:Survivors; D055815:Young Adult