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Role of oncologists and primary care physicians in providing follow-up care to non-Hodgkin lymphoma survivors within 5 years of diagnosis: a population-based study

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Abstract

Purpose

The growing population of non-Hodgkin lymphoma (NHL) survivors living longer with high physical and psychological treatment burden, in combination with the projected shortage of medical professionals, necessitates redesigning cancer follow-up care. This study examined follow-up care patterns, factors associated with follow-up care, and attitudes towards follow-up care among NHL survivors.

Methods

We surveyed survivors of aggressive NHL 2 to 5 years post-diagnosis (N = 363) using a population-based sample from the Los Angeles County Surveillance Epidemiology and End Results registry.

Results

Most survivors (82 %) received cancer-related follow-up care in the past year from an oncologist. History of recurrence, more comorbidities, more symptoms, and a shorter survivor–oncologist relationship were associated with high-frequency care with the oncologist [(≥5 visits in the past year), p < 0.05]. Many survivors followed up by oncologists (71 %) also saw a primary care provider (PCP) and 47 % also saw both a PCP and other specialists. Factors associated with seeing a PCP in addition to an oncologist included more symptoms, more health information needs, no history of recurrence, perceived excellent quality of cancer follow-up care, and fewer visits with the oncologist (p < 0.05). Survivors generally reported high reassurance from, and low negative anticipation towards, follow-up care.

Conclusions

The high proportion of NHL survivors receiving care from multiple physicians, and the sizable proportion (∼30 %) who have not recently seen a PCP, suggests that coordinating care across specialties is critical to ensure comprehensive, non-duplicative care. Understanding factors associated with cancer-related follow-up is a first step towards more effective, efficient, patient-centered care.

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Acknowledgments

This study was supported in part by the California Department of Health Services as part of the statewide cancer reporting program mandated by California Health and Safety Code Section 103885; by National Cancer Institute Surveillance, Epidemiology, and End Results Program Contract No. N01-PC-35139 awarded to the University of Southern California and Contract No. N02-PC-15105 awarded to the Public Health Institute; and by Centers for Disease Control and Prevention National Program of Cancer Registries Agreement No. U55/CCR921930-02 awarded to the Public Health Institute. Selected findings from this manuscript were presented in abstract form at the Annual Meeting of the American Society of Clinical Oncology in June 2001 in Chicago, IL.

Conflict of interest

The authors have no conflicts of interest to report.

Disclaimer

The opinions expressed herein are those of the author(s) and may not reflect those of the Patient-Centered Outcomes Research Institute or any government agency, their contractors, or subcontractors. There are no financial disclosures to report.

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Authors and Affiliations

  1. Patient-Centered Outcomes Research Institute (PCORI), 1828 L Street, NW, Suite 900, Washington, DC, 20036, USA

    Laura P. Forsythe

  2. Office of Cancer Survivorship, Division of Cancer Control and Population Sciences, National Cancer Institute, NIH/DHHS, Bethesda, MD, USA

    Laura P. Forsythe, Catherine M. Alfano & Julia H. Rowland

  3. Cancer Prevention Fellowship Program, Center for Cancer Training, National Cancer Institute, NIH/DHHS, Bethesda, MD, USA

    Laura P. Forsythe

  4. Applied Research Program, Division of Cancer Control and Population Sciences, National Cancer Institute, NIH/DHHS, Bethesda, MD, USA

    Neeraj K. Arora

  5. Department of Social Sciences & Health Policy, Division of Public Health Sciences, Wake Forest School of Medicine, Winston-Salem, NC, USA

    Kathryn E. Weaver

  6. Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA

    Ann S. Hamilton

  7. Office of Extramural Programs, National Institute of Nursing Research, Bethesda, MD, USA

    Noreen Aziz

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  1. Laura P. Forsythe
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  7. Julia H. Rowland
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Correspondence to Laura P. Forsythe.

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Forsythe, L.P., Arora, N.K., Alfano, C.M. et al. Role of oncologists and primary care physicians in providing follow-up care to non-Hodgkin lymphoma survivors within 5 years of diagnosis: a population-based study. Support Care Cancer 22, 1509–1517 (2014). https://doi.org/10.1007/s00520-013-2113-z

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  • DOI: https://doi.org/10.1007/s00520-013-2113-z

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