Journal of General Internal Medicine

, Volume 26, Issue 12, pp 1403–1410 | Cite as

Differences Between Primary Care Physicians’ and Oncologists’ Knowledge, Attitudes and Practices Regarding the Care of Cancer Survivors

  • Arnold L. PotoskyEmail author
  • Paul K. J. Han
  • Julia Rowland
  • Carrie N. Klabunde
  • Tenbroeck Smith
  • Noreen Aziz
  • Craig Earle
  • John Z. Ayanian
  • Patricia A. Ganz
  • Michael Stefanek
Original Research



The growing number of cancer survivors combined with a looming shortage of oncology specialists will require greater coordination of post-treatment care responsibilities between oncologists and primary care physicians (PCPs). However, data are limited regarding these physicians’ views of cancer survivors’ care.


To compare PCPs and oncologists with regard to their knowledge, attitudes, and practices for follow-up care of breast and colon cancer survivors.

Design and Subjects

Mailed questionnaires were completed by a nationally representative sample of 1,072 PCPs and 1,130 medical oncologists in 2009 (cooperation rate = 65%). Sampling and non-response weights were used to calculate estimates to reflect practicing US PCPs and oncologists.

Main Measures

PCPs and oncologists reported their 1) preferred model for delivering cancer survivors’ care; 2) assessment of PCPs’ ability to perform follow-up care tasks; 3) confidence in their knowledge; and 4) cancer surveillance practices.

Key Results

Compared with PCPs, oncologists were less likely to believe PCPs had the skills to conduct appropriate testing for breast cancer recurrence (59% vs. 23%, P < 0.001) or to care for late effects of breast cancer (75% vs. 38%, P < 0.001). Only 40% of PCPs were very confident of their own knowledge of testing for recurrence. PCPs were more likely than oncologists to endorse routine use of non-recommended blood and imaging tests for detecting cancer recurrence, with both groups departing substantially from guideline recommendations.


There are significant differences in PCPs’ and oncologists’ knowledge, attitudes, and practices with respect to care of cancer survivors. Improving cancer survivors’ care may require more effective communication between these two groups to increase PCPs’ confidence in their knowledge, and must also address oncologists’ attitudes regarding PCPs’ ability to care for cancer survivors.

Key Words

cancer care cancer survivorship physician survey physician attitudes 



The authors gratefully acknowledge those who have contributed significantly to this work: The staff of Westat Inc., (Bethesda, MD) who helped in the design and planning of the SPARCCS survey, and who collected all of the survey data; and Ms. Tania Lobo, M.S., at Georgetown University, who provided assistance with data analysis.

Funding for the Survey of Physicians Attitudes Regarding the Care of Cancer Survivors (SPARCCS) was provided by National Cancer Institute (Contract numberHSN261200700068C) and the American Cancer Society Intramural Research funds. The views expressed in this article do not necessarily represent the views of either the federal government or the American Cancer Society.

Selected findings in this article were presented at the 5th Biennial Cancer Survivorship Research Conference: Recovery and Beyond, June 2010, Washington, DC.

Conflict of Interest

None Disclosed.

Supplementary material

11606_2011_1808_MOESM1_ESM.pdf (292 kb)
ESM 1 (PDF 292 kb)
11606_2011_1808_MOESM2_ESM.pdf (290 kb)
ESM 2 (PDF 289 kb)


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Copyright information

© Society of General Internal Medicine 2011

Authors and Affiliations

  • Arnold L. Potosky
    • 1
    Email author
  • Paul K. J. Han
    • 2
  • Julia Rowland
    • 3
  • Carrie N. Klabunde
    • 4
  • Tenbroeck Smith
    • 5
  • Noreen Aziz
    • 6
  • Craig Earle
    • 7
  • John Z. Ayanian
    • 8
  • Patricia A. Ganz
    • 9
  • Michael Stefanek
    • 10
  1. 1.Lombardi Comprehensive Cancer Center, Cancer Control ProgramGeorgetown University Medical CenterWashingtonUSA
  2. 2.Center for Outcomes Research and EvaluationMaine Medical CenterPortlandUSA
  3. 3.Office of Cancer Survivorship, Division of Cancer Control and Population SciencesNational Cancer InstituteBethesdaUSA
  4. 4.Applied Research Program, Division of Cancer Control and Population SciencesNational Cancer InstituteBethesdaUSA
  5. 5.Behavioral Research Center, Intramural Research DepartmentAmerican Cancer SocietyAtlantaUSA
  6. 6.National Institute of Nursing ResearchBethesdaUSA
  7. 7.Institute for Clinical Evaluative SciencesTorontoCanada
  8. 8.Division of General Medicine, Brigham and Women’s Hospital; Department of Health Care PolicyHarvard Medical SchoolBostonUSA
  9. 9.Schools of Public Health and Medicine, Jonsson Comprehensive Cancer CenterUniversity of CaliforniaLos AngelesUSA
  10. 10.Rollins School of Public HealthEmory UniversityAtlantaUSA

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