title: Physician roles in the cancer-related follow-up care of cancer survivors.
abstract: OBJECTIVE
  Information about primary care physicians' (PCPs) and oncologists' involvement in cancer-related follow-up care, and care coordination practices, is lacking but essential to improving cancer survivors' care. This study assesses PCPs' and oncologists' self-reported roles in providing cancer-related follow-up care for survivors who are within 5 years of completing cancer treatment.
  
  
  METHODS
  In 2009, the National Cancer Institute and the American Cancer Society conducted a nationally representative survey of PCPs (n=1,014) and medical oncologists (n=1,125) (response rate=57.6%, cooperation rate=65.1%). Mailed questionnaires obtained information on physicians' roles in providing cancer-related follow-up care to early-stage breast and colon cancer survivors, personal and practice characteristics, beliefs about and preferences for follow-up care, and care coordination practices.
  
  
  RESULTS
  More than 50% of PCPs reported providing cancer-related follow-up care for survivors, mainly by co-managing with an oncologist. In contrast, more than 70% of oncologists reported fulfilling these roles by providing the care themselves. In adjusted analyses, PCP co-management was associated with specialty, training in late or long-term effects of cancer, higher cancer patient volume, favorable attitudes about PCP care involvement, preference for a shared model of survivorship care, and receipt of treatment summaries from oncologists. Among oncologists, only preference for a shared care model was associated with co-management with PCPs.
  
  
  CONCLUSIONS
  PCPs and oncologists differ in their involvement in cancer-related follow-up care of survivors, with co-management more often reported by PCPs than by oncologists. Given anticipated national shortages of PCPs and oncologists, study results suggest that improved communication and coordination between these providers is needed to ensure optimal delivery of follow-up care to cancer survivors.
authors.affiliation: Applied Research Program, Division of Cancer Control and Population Sciences, National Cancer Institute, Bethesda, MD 20892-7344, USA. KlabundC@mail.nih.gov
authors.forename: Carrie N
authors.initials: CN
authors.lastname: Klabunde
authors.forename: Paul K J
authors.initials: PK
authors.lastname: Han
authors.forename: Craig C
authors.initials: CC
authors.lastname: Earle
authors.forename: Tenbroeck
authors.initials: T
authors.lastname: Smith
authors.forename: John Z
authors.initials: JZ
authors.lastname: Ayanian
authors.forename: Richard
authors.initials: R
authors.lastname: Lee
authors.forename: Anita
authors.initials: A
authors.lastname: Ambs
authors.forename: Julia H
authors.initials: JH
authors.lastname: Rowland
authors.forename: Arnold L
authors.initials: AL
authors.lastname: Potosky
mesh_terms: D000328:Adult; D000359:Aftercare / Q000458:organization & administration*; D001943:Breast Neoplasms / Q000628:therapy*; D003110:Colonic Neoplasms / Q000628:therapy*; D003625:Data Collection; D005260:Female; D006801:Humans; D008297:Male; D008495:Medical Oncology / Q000458:organization & administration* / Q000706:statistics & numerical data; D008875:Middle Aged; D010819:Physician's Role; D011320:Primary Health Care / Q000458:organization & administration* / Q000706:statistics & numerical data; D012044:Regression Analysis; D017741:Survivors