Differences Between Primary Care Physicians’ and Oncologists’ Knowledge, Attitudes and Practices Regarding the Care of Cancer Survivors
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.
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.
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 Wordscancer 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
- 1.Edwards BK, Ward E, Kohler BA, Eheman C, Zauber AG, Anderson RN, et al. Annual report to the nation on the status of cancer, 1975–2006, featuring colorectal cancer trends and impact of interventions (risk factors, screening, and treatment) to reduce future rates. Cancer. 2010;116:544–73.PubMedCrossRefGoogle Scholar
- 2.Hewitt M, Greenfield S, Stovall E. From cancer patient to cancer survivor: Lost in transition. Washington: Institute of Medicine, National Academies Press; 2005.Google Scholar
- 8.Bunnell CA. Will We Be Able to Care For Cancer Patients In The Future? Oncology. 2011;24:1–9.Google Scholar
- 31.Standard definitions: final dispositions of case codes and outcome rates for surveys. 6th edition. 2009. American Association for Public Opinion Research.Google Scholar
- 41.National Comprehensive Cancer Network. NCCN Clinical Practice Guidelines in Oncology™. Breast Cancer Guidelines, Version 2.2008. 2008.Google Scholar
- 42.National Comprehensive Cancer Network. NCCN Clinical Practice Guidelines in Oncology™. Colon Cancer Guidelines, Version 2.2011. 1-1-2010.Google Scholar
- 45.Hewitt M, Ganz PA. Implementing Cancer Survivorship Care Planning: Workshop Summary. Washington: Institute of Medicine, National Academies Press; 2007.Google Scholar