title: Clinical and organizational issues in the management of surviving breast and colorectal cancer patients: attitudes and feelings of medical oncologists.
abstract: BACKGROUND
  The fast growing demand and the shortage of resources are pushing toward more efficient models of survivorship care delivery. The Associazione Italiana di Oncologia Medica (AIOM) established an interdisciplinary working group with the purpose of promoting organizational improvements at the national level. A survey aimed at assessing attitudes and feelings of oncologists was considered preliminary to further initiatives.
  
  
  METHODS
  A 25-item questionnaire, sent to the mailing list of the Society, explored the following issues on the practice of breast and colorectal cancer patients' follow up: 1) organization; 2) clinical features; 3) feelings about the different meanings of follow-up.
  
  
  RESULTS
  Ninety-one oncologists of 160 institutions (57%) answered to the questionnaire. Although follow up is considered a distinct oncological activity in 68%, a fully shared organization between specialists is not common and communications with Primary Care Physicians are not structured in the majority of the cases. Fifty-five and 30% of the oncologists follow breast and colorectal cancer patients indefinitely. In case of discharge a survivorship care plan is delivered in only 9%. The majority of respondents do not hold a role of follow up in mortality reduction.
  
  
  CONCLUSIONS
  Although survivorship care represents a significant part of the oncologists' workload, an "oncology-centered" model is largely adopted and established care pathways are still incomplete. Survivorship care needs to be put at the center of an educational policy and of a widespread organizational effort, directed at improving appropriateness and quality.
authors.affiliation: Medical Oncology Unit, Azienda USL della Valle d'Aosta, Aosta, Italy.
authors.forename: Gianmauro
authors.initials: G
authors.lastname: Numico
authors.affiliation: Medical Oncology Unit, S. Orsola-Malpighi Hospital, Bologna, Italy.
authors.forename: Carmine
authors.initials: C
authors.lastname: Pinto
authors.affiliation: Medical Oncology, Sacro Cuore Don Calabria Hospital, Verona, Italy.
authors.forename: Stefania
authors.initials: S
authors.lastname: Gori
authors.affiliation: Oncology Department, Azienda Ospedaliera di Lodi, Lodi, Italy.
authors.forename: Giovanni
authors.initials: G
authors.lastname: Ucci
authors.affiliation: Clinical Trial Unit, National Cancer Institute "G. Pascale" Foundation, Napoli, Italy.
authors.forename: Massimo
authors.initials: M
authors.lastname: Di Maio
authors.affiliation: Società Italiana di Medicina Generale (SIMG), Conegliano, Italy.
authors.forename: Maurizio
authors.initials: M
authors.lastname: Cancian
authors.affiliation: Federazione Associazioni di Volontariato in Oncologia (FAVO), Roma, Italy.
authors.forename: Francesco
authors.initials: F
authors.lastname: De Lorenzo
authors.affiliation: Medical Oncology Unit, National Cancer Research Centre "Giovanni Paolo II", Bari, Italy.
authors.forename: Nicola
authors.initials: N
authors.lastname: Silvestris
mesh_terms: D001291:Attitude of Health Personnel; D001943:Breast Neoplasms / Q000628:therapy*; D015179:Colorectal Neoplasms / Q000628:therapy*; D005260:Female; D006801:Humans; D008297:Male; D008495:Medical Oncology; D011795:Surveys and Questionnaires; D000078329:Workforce