Cancer survivors' perspectives on delivery of survivorship care by primary care physicians: an internet-based survey.
BACKGROUND
Helping cancer survivors to transition from active treatment to long-term survivorship requires coordinated efforts by both oncologists and primary care physicians (PCPs). This study aims to evaluate cancer survivors' perspectives on PCP-delivered survivorship care.


METHODS
We conducted an Internet-based cross-sectional survey of cancer survivors via www.OncoLink.org . Regression analyses were used to identify factors associated with perception of PCP-delivered survivorship care.


RESULTS
The 352 respondents rated overall PCP-delivered survivorship care as 60 out of 100 (SD = 23). The areas of care most strongly endorsed were general care (62 %), psychosocial support (65 %), and holistic care (68 %). Survivors were less likely to perceive their PCPs as knowledgeable about cancer follow-up (43 %), late or long-term effects of cancer therapy (45 %), and diagnosis and treatment of symptoms related to cancer or cancer therapy (42 %). While 72 % of survivors reported satisfaction with their PCP's care overall, only 41 % felt that their PCPs and oncologists communicated well with one another. In a multivariate regression analysis, higher trust in PCP (p < 0.001), non-white race (p = 0.001), living in the United States (p = 0.007), and visiting a PCP two or more times per year (p = 0.009) were significantly associated with higher ratings of PCP-delivered survivorship care.


CONCLUSIONS
While cancer survivors in general are satisfied with care delivery by PCPs, they perceived that their PCPs have limited abilities in performing cancer-specific follow-up and late effect monitoring and treatment. Better education of family physicians about survivorship issues and improved communication between PCPs and oncologists are needed to improve PCPs' delivery of survivorship care.
Perelman School of Medicine at the University of Pennsylvania, Pennsylvania, USA. Ernestina.nyarko@gmail.com.
Ernestina
E
Nyarko
Department of Radiation Oncology, University of Pennsylvania, Pennsylvania, USA. metz@uphs.upenn.edu.|Abramson Cancer Center, University of Pennsylvania, Pennsylvania, USA. metz@uphs.upenn.edu.
James M
JM
Metz
Department of Family Medicine and Community Health, University of Pennsylvania, 227 Blockley Hall, 423 Guardian Drive, Philadelphia, PA, 19104-6021, USA. Giang.nguyen@uphs.upenn.edu.|Abramson Cancer Center, University of Pennsylvania, Pennsylvania, USA. Giang.nguyen@uphs.upenn.edu.|Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania, Pennsylvania, USA. Giang.nguyen@uphs.upenn.edu.
Giang T
GT
Nguyen
Department of Radiation Oncology, University of Pennsylvania, Pennsylvania, USA. Maggie.hampshire@uphs.upenn.edu.|Abramson Cancer Center, University of Pennsylvania, Pennsylvania, USA. Maggie.hampshire@uphs.upenn.edu.
Margaret K
MK
Hampshire
Abramson Cancer Center, University of Pennsylvania, Pennsylvania, USA. Linda.jacobs@uphs.upenn.edu.
Linda A
LA
Jacobs
Department of Family Medicine and Community Health, University of Pennsylvania, 227 Blockley Hall, 423 Guardian Drive, Philadelphia, PA, 19104-6021, USA. maoj@uphs.upenn.edu.|Abramson Cancer Center, University of Pennsylvania, Pennsylvania, USA. maoj@uphs.upenn.edu.|Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania, Pennsylvania, USA. maoj@uphs.upenn.edu.
Jun J
JJ
Mao
D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000628:therapy*; D058007:Physicians, Primary Care / Q000592:standards; D011787:Quality of Health Care / Q000592:standards; D011795:Surveys and Questionnaires; D017741:Survivors / Q000523:psychology*