title: Practice patterns and perceptions of survivorship care in Canadian genitourinary oncology: A multidisciplinary perspective.
abstract: BACKGROUND
  There is little knowledge of survivorship care specific to genitourinary (GU) cancers. To improve care delivery to this patient population, we need to clearly define physician perceptions of survivorship care. We therefore conducted a study to determine the challenges to GU cancer survivorship care in Canada.
  
  
  METHODS
  A web-based questionnaire was e-mailed to physicians treating GU cancers in Canada, including urologists, radiation oncologists, and medical oncologists. Five domains were assessed: demography, current post-cancer treatment care, perspectives on barriers to survivorship care, accessibility to survivorship resources, and perspectives about advocacy groups.
  
  
  RESULTS
  There were 306 responses, with 260 eligible for study. A total of 82% of physicians involve primary care practitioners (PCPs) at some point in survivorship care. Most physicians provide some form of written follow-up plan to PCPs. However, only 25% provided lifestyle recommendations and 53% included persistent and late effects of therapy. Lack of time or resources dedicated to survivorship care was the most commonly reported barrier. There was variation in accessibility to survivorship support programs among different subspecialties and regions. Advocacy groups generally were underutilized, particularly in testis cancer. Low response rate and the potential response bias are the main limitations of this survey.
  
  
  CONCLUSIONS
  To our knowledge this is the first study to address the challenges of GU cancer survivorship care in Canada. The barriers and accessibility of survivorship care quoted in this survey may be used to improve care for this group of patients. Underutilization of advocacy groups may stimulate the advocacy groups and institutions to address its causes and solutions.
authors.affiliation: Departments of Surgery (Urology) and Surgical Oncology, Princess Margaret Cancer Centre, University Health Network and the University of Toronto, Toronto, ON;
authors.forename: Ashraf
authors.initials: A
authors.lastname: Almatar
authors.affiliation: Department of Medical Oncology, Princess Margaret Cancer Centre, University Health Network and the University of Toronto, Toronto, ON;
authors.forename: Suzanne
authors.initials: S
authors.lastname: Richter
authors.affiliation: Radiation Medicine Program, Princess Margaret Cancer Centre, University Health Network and the University of Toronto, Toronto, ON;
authors.forename: Nafisha
authors.initials: N
authors.lastname: Lalani
authors.affiliation: ELLICSR: Health, Wellness and Cancer Survivorship Centre, Toronto General Hospital, University Health Network and the University of Toronto, Toronto, ON;
authors.forename: Jackie L
authors.initials: JL
authors.lastname: Bender
authors.affiliation: ELLICSR: Health, Wellness and Cancer Survivorship Centre, Toronto General Hospital, University Health Network and the University of Toronto, Toronto, ON;
authors.forename: David
authors.initials: D
authors.lastname: Wiljer
authors.affiliation: ELLICSR: Health, Wellness and Cancer Survivorship Centre, Toronto General Hospital, University Health Network and the University of Toronto, Toronto, ON;
authors.forename: Nour
authors.initials: N
authors.lastname: Alkazaz
authors.affiliation: Departments of Surgery (Urology) and Surgical Oncology, Princess Margaret Cancer Centre, University Health Network and the University of Toronto, Toronto, ON;
authors.forename: Laura
authors.initials: L
authors.lastname: Legere
authors.affiliation: Department of Biostatistics, Princess Margaret Cancer Centre, University Health Network and the University of Toronto, Toronto, ON.
authors.forename: Manjula
authors.initials: M
authors.lastname: Maganti
authors.affiliation: Department of Medical Oncology, Princess Margaret Cancer Centre, University Health Network and the University of Toronto, Toronto, ON;
authors.forename: Srikala S
authors.initials: SS
authors.lastname: Sridhar
authors.affiliation: Radiation Medicine Program, Princess Margaret Cancer Centre, University Health Network and the University of Toronto, Toronto, ON; ; ELLICSR: Health, Wellness and Cancer Survivorship Centre, Toronto General Hospital, University Health Network and the University of Toronto, Toronto, ON;
authors.forename: Pamela P
authors.initials: PP
authors.lastname: Catton
authors.affiliation: Departments of Surgery (Urology) and Surgical Oncology, Princess Margaret Cancer Centre, University Health Network and the University of Toronto, Toronto, ON;
authors.forename: Michael A S
authors.initials: MA
authors.lastname: Jewett