Journal of Cancer Survivorship

, Volume 5, Issue 4, pp 358-370

First online:

Survivorship care planning after the Institute of Medicine recommendations: how are we faring?

  • Carrie Tompkins StrickerAffiliated withAbramson Cancer Center at the University of Pennsylvania Email author 
  • , Linda A. JacobsAffiliated withAbramson Cancer Center at the University of Pennsylvania
  • , Betsy RisendalAffiliated withUniversity of Colorado Cancer Center
  • , Alison JonesAffiliated withUniversity of Colorado Cancer Center
  • , Sarahlena PanzerAffiliated withAbramson Cancer Center at the University of Pennsylvania
  • , Patricia A. GanzAffiliated withUCLA Schools of Medicine & Public Health, Jonsson Comprehensive Cancer Center
  • , Karen L. SyrjalaAffiliated withClinical Research Division, Fred Hutchinson Cancer Research Center: Survivorship Program
  • , Mary S. McCabeAffiliated withMemorial Sloan-Kettering Cancer Center: Survivorship Program
  • , K. Scott BakerAffiliated withPediatric Blood and Marrow Transplantation and Survivorship Programs, Fred Hutchinson Cancer Research Center
    • , Kenneth MillerAffiliated withDana-Farber Cancer Institute
    • , Jacqueline CasillasAffiliated withDavid Geffen School of Medicine at UCLA, Department of Pediatrics, Division of Hematology/Oncology
    • , Donald L. RosensteinAffiliated withDepartments of Psychiatry and Medicine, Comprehensive Cancer Support Program, North Carolina Cancer Hospital and Lineberger Cancer Center, University of North Carolina at Chapel Hill
    • , Marci CampbellAffiliated withNorth Carolina Cancer Hospital and Lineberger Cancer Center, University of North Carolina at Chapel Hill
    • , Steven C. PalmerAffiliated withAbramson Cancer Center at the University of Pennsylvania

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This study evaluates the concordance of treatment summaries (TSs) and survivorship care plans (SCPs) delivered to breast cancer survivors within the LIVESTRONG™ Network of Survivorship Centers of Excellence with Institute of Medicine (IOM) recommendations and describes additional structure/process variables.


Seven NCI-designated comprehensive cancer centers and six community-based centers participated. TS/SCPs for 65 patients were rated against IOM recommendations using a study-derived checklist, and surveys were administered to better understand the structure and process of delivering TSs/SCPs.


On average, fewer than half of IOM content recommendations were met for TSs (M = 46%) and less than two thirds for SCPs (M = 59%). No sites achieved ≥75% overall concordance with IOM recommendations for TSs and only two of 13 met this criterion for SCPs. Content domain scores across sites varied widely, as did the number of sites addressing domain content with ≥75% concordance. Nonetheless, resources required for document preparation and delivery were substantial.


Gaps in concordance with IOM recommendations exist even in dedicated survivorship centers. A substantial time burden was also noted. Further research is needed to determine which informational elements are essential, to develop and test strategies for improving efficiency and reach, and to determine if outcomes of survivorship care planning warrant the resources required in their preparation and delivery.

Implications for survivors

TSs and SCPs have been recommended for all cancer survivors. Essential elements must be determined, approaches made more efficient, outcome improvements demonstrated, and cost-benefit analyses determined before survivors should expect widespread implementation of this recommendation for survivorship care.


Treatment summaries Survivorship care plans/planning Breast cancer survivorship