title: Family physician preferences and knowledge gaps regarding the care of adolescent and young adult survivors of childhood cancer.
abstract: OBJECTIVE
  Childhood cancer survivors are at risk for long-term morbidity and early mortality. Since most adult and some adolescent survivors of childhood cancer will receive their long-term care from a primary care physician, we sought to determine family physicians' comfort with caring for this population.
  
  
  METHODS
  A survey was mailed to 2,520 United States (US) and Canadian family physicians to assess their attitudes and knowledge regarding the care of adolescent and young adult survivors of childhood cancer.
  
  
  RESULTS
  One thousand one hundred twenty-four family physicians responded (704 US, 420 Canadian). Median age was 53 years; 63 % were men; 81 % had cared for ≤2 childhood cancer survivors in the past 5 years. Of those who had cared for a survivor, 48 % had never or almost never received a treatment summary from the referring cancer center; 85 % preferred to care for survivors in consultation with a cancer center-based physician or long-term follow-up program. Only 33, 27, and 23 % of respondents were very comfortable caring for survivors of childhood Hodgkin lymphoma, acute lymphoblastic leukemia or osteosarcoma, respectively. Only 16, 10, and 74 % of respondents correctly identified the guideline recommended surveillance for secondary breast cancer, cardiac dysfunction and hypothyroidism in response to a vignette describing a Hodgkin lymphoma survivor. Respondents rated access to clinical care guidelines and receipt of a patient-specific letter from specialists with surveillance recommendations as the modalities most likely to assist them in caring for survivors.
  
  
  CONCLUSIONS
  Most family physicians are willing to care for childhood cancer survivors in consultation with a cancer center, and with specific tools to facilitate this care.
  
  
  CONCLUSIONS
  Adult and adolescent survivors of childhood cancer who receive their follow-up care from a family physician must be empowered to choose a physician who is comfortable with caring for survivors. Further, the survivor must ensure that their physician has access to a treatment summary as well as to patient-specific recommendations for surveillance for late effects of cancer therapy.
authors.affiliation: Hospital for Sick Children, 555 University Avenue, Toronto, ON, Canada. paul.nathan@sickkids.ca
authors.forename: Paul Craig
authors.initials: PC
authors.lastname: Nathan
authors.forename: Christopher Keller
authors.initials: CK
authors.lastname: Daugherty
authors.forename: Kristen Elizabeth
authors.initials: KE
authors.lastname: Wroblewski
authors.forename: Mackenzie Louise
authors.initials: ML
authors.lastname: Kigin
authors.forename: Tom Vernon
authors.initials: TV
authors.lastname: Stewart
authors.forename: Fay Jarmila
authors.initials: FJ
authors.lastname: Hlubocky
authors.forename: Eva
authors.initials: E
authors.lastname: Grunfeld
authors.forename: Marie Elisabeth
authors.initials: ME
authors.lastname: Del Giudice
authors.forename: Leigh-Anne Evelyn
authors.initials: LA
authors.lastname: Ward
authors.forename: James Mahlon
authors.initials: JM
authors.lastname: Galliher
authors.forename: Kevin Charles
authors.initials: KC
authors.lastname: Oeffinger
authors.forename: Tara Olive
authors.initials: TO
authors.lastname: Henderson
mesh_terms: D000293:Adolescent; D016497:Adolescent Health Services / Q000706:statistics & numerical data; D000328:Adult; D017668:Age of Onset; D002170:Canada / Q000453:epidemiology; D002648:Child; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000453:epidemiology / Q000523:psychology / Q000534:rehabilitation; D010821:Physicians, Family / Q000193:education* / Q000523:psychology* / Q000706:statistics & numerical data; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data; D017741:Survivors / Q000523:psychology / Q000706:statistics & numerical data; D014481:United States / Q000453:epidemiology; D055815:Young Adult