Skip to main content

Advertisement

SpringerLink
Log in

Follow-up patterns of cancer survivors: a survey of Canadian radiation oncologists

  • Published:
Journal of Cancer Survivorship Aims and scope Submit manuscript

Abstract

Purpose

With continual advancements in cancer care, improved outcomes, and increasing survivors, survivorship has become an important area of research. This project seeks to determine the current status of follow-up care in oncology.

Methods

An electronic survey was sent to the Canadian Association of Radiation Oncology members. Based on brief clinical scenarios pertaining to various survivor populations, questions were posed to determine routine follow-up practices.

Results

One hundred eleven radiation oncologists (RO) responded (44 % response rate); 29 % were female, 43 % were in practice <10 years, and most of Canada was represented. Most worked in centers with >10 oncologists (69 %) and saw >200 new consults per year (78 %). Only 10 % reported not following their patients routinely, mainly in those with breast cancer. Most would follow their central nervous system, gastrointestinal, head and neck, gynecologic, and genitourinary patients. Lack of resources and a belief that follow-up by family physicians (FPs) is equally effective were the top reasons for not following. Treatment toxicity and possibility of further treatment were the most common reasons for routine follow-up. The majority (55 %) would follow patients for <5 years, with 36 % for 5–10 years, and a minority (9 %) for longer than 10 years; 54 % would not change the frequency of follow-up, but 39 % would decrease and only 7 % would increase follow-up. Some felt transferring more care to other health professionals would require additional training and more guidelines. Survivorship care plans are underutilized.

Conclusions

Transfer of follow-up care to FPs is desired and feasible. This would allow for more comprehensive medical care and improve access to care for newly diagnosed patients. The development and usage of survivorship care plans would improve this care.

Implications for cancer survivors

Survivors may be increasingly followed by family physicians. Better coordination between oncologists and family physicians, including the use of survivorship care plans, may facilitate this transition.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Hewitt M, Greenfield S, Stovall E. From cancer patient to cancer survivor: lost in transition. Washington: The National Academies Press; 2006.

  2. Ristovski-Slijepcevic S. Environmental scan of cancer survivorship in Canada: conceptualization, practice and research. 2008. http://www.partnershipagainstcancer.ca/wp-content/uploads/Survivorship_Svetlana_Ristovski-Slijepcevic.pdf. Accessed 2 Aug 2014.

  3. Tjandra JJ, Chan MK. Follow-up after curative resection of colorectal cancer: a meta-analysis. Dis Colon Rectum. 2007;50:1783–99.

    Article  PubMed  Google Scholar 

  4. Jeffery M, Hickey BE, Hider PN. Follow-up strategies for patients treated for non-metastatic colorectal cancer. Cochrane Database Syst Rev. 2007;1, CD002200.

    PubMed  Google Scholar 

  5. Renehan AG, Egger M, Saunders MP, O'Dwyer ST. Impact on survival of intensive follow up after curative resection for colorectal cancer: systematic review and meta-analysis of randomised trials. BMJ. 2002;324:813.

    Article  PubMed Central  PubMed  Google Scholar 

  6. Rosen M, Chan L, Beart Jr RW, Vukasin P, Anthone G. Follow-up of colorectal cancer: a meta-analysis. Dis Colon Rectum. 1998;41:1116–26.

    Article  CAS  PubMed  Google Scholar 

  7. Figueredo A, Rumble RB, Maroun J, et al. Follow-up of patients with curatively resected colorectal cancer: a practice guideline. BMC Cancer. 2003;3:26.

    Article  PubMed Central  PubMed  Google Scholar 

  8. Papagrigoriadis S. Follow-up of patients with colorectal cancer: the evidence is in favour but we are still in need of a protocol. Int J Surg. 2007;5:120–8.

    Article  PubMed  Google Scholar 

  9. Augestad KM, Rose J, Crawshaw B, Cooper G, Delaney C. Do the benefits outweigh the side effects of colorectal cancer surveillance? A systematic review. World J Gastrointest Oncol. 2014;6:104–11.

    Article  PubMed Central  PubMed  Google Scholar 

  10. Kew FM, Roberts AP, Cruickshank DJ. The role of routine follow-up after gynecological malignancy. Int J Gynecol Cancer. 2005;15:413–9.

    Article  CAS  PubMed  Google Scholar 

  11. Kew FM, Cruickshank DJ. Routine follow-up after treatment for a gynecological cancer: a survey of practice. Int J Gynecol Cancer. 2006;16:380–4.

    Article  CAS  PubMed  Google Scholar 

  12. Vistad I, Moy BW, Salvesen HB, Liavaag AH. Follow-up routines in gynecological cancer—time for a change? Acta Obstet Gynecol Scand. 2011;90:707–18.

    Article  PubMed  Google Scholar 

  13. Dalbagni G, Bochner BH, Cronin A, Herr HW, Donat SM. A plea for a uniform surveillance schedule after radical cystectomy. J Urol. 2011;185:2091–6.

    Article  PubMed  Google Scholar 

  14. Richert-Boe KE. Heterogeneity of cancer surveillance practices among medical oncologists in Washington and Oregon. Cancer. 1995;75:2605–12.

    Article  CAS  PubMed  Google Scholar 

  15. Schwartz DL, Barker Jr J, Chansky K, et al. Postradiotherapy surveillance practice for head and neck squamous cell carcinoma—too much for too little? Head Neck. 2003;25:990–9.

    Article  PubMed  Google Scholar 

  16. Virgo KS, McKirgan LW, Caputo MC, et al. Post-treatment management options for patients with lung cancer. Ann Surg. 1995;222:700–10.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  17. Virgo KS, Chan D, Handler BS, Johnson DY, Goshima K, Johnson FE. Current practice of patient follow-up after potentially curative resection of cutaneous melanoma. Plast Reconstr Surg. 2000;106:590–7.

    Article  CAS  PubMed  Google Scholar 

  18. Parmeshwar R, Margenthaler JA, Allam E, Chen L, Virgo KS, Johnson FE. Patient surveillance after initial breast cancer therapy: variation by physician specialty. Am J Surg. 2013;206:218–22.

    Article  PubMed  Google Scholar 

  19. National Physician Survey: Results for medical specialists. 2010. http://nationalphysiciansurvey.ca/result/2010-med/. Accessed 2 Aug 2014.

  20. Zlomislic D. Number of specialized doctors who are unemployed growing, study finds. Toronto Star 2013;News, Canada. http://www.thestar.com/news/canada/2013/10/10/number_of_specialized_doctors_who_are_unemployed_growing_study_finds.html

  21. Grunfeld E, Mant D, Yudkin P, et al. Routine follow up of breast cancer in primary care: randomised trial. BMJ. 1996;313:665–9.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  22. Del Giudice ME, Grunfeld E, Harvey BJ, Piliotis E, Verma S. Primary care physicians’ views of routine follow-up care of cancer survivors. J Clin Oncol. 2009;27:3338–45.

    Article  PubMed  Google Scholar 

  23. Ganz PA. Survivorship: adult cancer survivors. Prim Care. 2009;36:721–41.

    Article  PubMed  Google Scholar 

  24. Salz T, McCabe MS, Onstad EE, et al. Survivorship care plans: is there buy-in from community oncology providers? Cancer. 2014;120:722–30.

    Article  PubMed Central  PubMed  Google Scholar 

  25. Mayer DK, Gerstel A, Walton AL, et al. Implementing survivorship care plans for colon cancer survivors. Oncol Nurs Forum. 2014;41:266–73.

    Article  PubMed  Google Scholar 

  26. Dulko D, Pace CM, Dittus KL, et al. Barriers and facilitators to implementing cancer survivorship care plans. Oncol Nurs Forum. 2013;40:575–80.

    Article  PubMed Central  PubMed  Google Scholar 

  27. Salz T, Oeffinger KC, McCabe MS, Layne TM, Bach PB. Survivorship care plans in research and practice. CA Cancer J Clin 2012;62(2):101–17.

  28. American Society of Clinical Oncology. ASCO Cancer Treatment Summaries.;2014. http://www.cancer.net/survivorship/follow-care-after-cancer-treatment/asco-cancer-treatment-summaries. Accessed 2 Aug 2014.

  29. Shayne M, Culakova E, Milano MT, Dhakal S, Constine LS. The integration of cancer survivorship training in the curriculum of hematology/oncology fellows and radiation oncology residents. J Cancer Surviv. 2014;8:167–72.

    Article  PubMed  Google Scholar 

Download references

Conflict of interest

The authors have no conflicts of interest to declare.

Role of the funding source

This research was funded in part by the Northern Cancer Control Strategy Discovery Grant.

Author information

Authors and Affiliations

  1. Department of Radiation Oncology, Vancouver Cancer Centre, British Columbia Cancer Agency, Vancouver, British Columbia, Canada

    Allison Y. Ye & Karen J. Goddard

  2. Department of Medical Oncology, Vancouver Cancer Centre, British Columbia Cancer Agency, Vancouver, British Columbia, Canada

    Winson Y. Cheung

  3. Northern Medical Program, Faculty of Medicine, University of Northern British Columbia, Prince George, British Columbia, Canada

    Daniel Horvat

  4. Department of Radiation Oncology, Center for the North, British Columbia Cancer Agency, 1215 Lethbridge Street, Prince George, British Columbia, V2N 7E9, Canada

    Robert A. Olson

Authors
  1. Allison Y. Ye
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Winson Y. Cheung
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Karen J. Goddard
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Daniel Horvat
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Robert A. Olson
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Robert A. Olson.

Appendix 1

Appendix 1

figure afigure afigure afigure afigure afigure afigure a

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Ye, A.Y., Cheung, W.Y., Goddard, K.J. et al. Follow-up patterns of cancer survivors: a survey of Canadian radiation oncologists. J Cancer Surviv 9, 388–403 (2015). https://doi.org/10.1007/s11764-014-0390-2

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11764-014-0390-2

Keywords

Search

Navigation