Journal of Cancer Survivorship

, Volume 7, Issue 3, pp 275–282 | Cite as

Family physician preferences and knowledge gaps regarding the care of adolescent and young adult survivors of childhood cancer

  • Paul Craig Nathan
  • Christopher Keller Daugherty
  • Kristen Elizabeth Wroblewski
  • Mackenzie Louise Kigin
  • Tom Vernon Stewart
  • Fay Jarmila Hlubocky
  • Eva Grunfeld
  • Marie Elisabeth Del Giudice
  • Leigh-Anne Evelyn Ward
  • James Mahlon Galliher
  • Kevin Charles Oeffinger
  • Tara Olive Henderson



Childhood cancer survivors are at risk for long-term morbidity and early mortality. Since most adult and some adolescent survivors of childhood cancer will receive their long-term care from a primary care physician, we sought to determine family physicians’ comfort with caring for this population.


A survey was mailed to 2,520 United States (US) and Canadian family physicians to assess their attitudes and knowledge regarding the care of adolescent and young adult survivors of childhood cancer.


One thousand one hundred twenty-four family physicians responded (704 US, 420 Canadian). Median age was 53 years; 63 % were men; 81 % had cared for ≤2 childhood cancer survivors in the past 5 years. Of those who had cared for a survivor, 48 % had never or almost never received a treatment summary from the referring cancer center; 85 % preferred to care for survivors in consultation with a cancer center-based physician or long-term follow-up program. Only 33, 27, and 23 % of respondents were very comfortable caring for survivors of childhood Hodgkin lymphoma, acute lymphoblastic leukemia or osteosarcoma, respectively. Only 16, 10, and 74 % of respondents correctly identified the guideline recommended surveillance for secondary breast cancer, cardiac dysfunction and hypothyroidism in response to a vignette describing a Hodgkin lymphoma survivor. Respondents rated access to clinical care guidelines and receipt of a patient-specific letter from specialists with surveillance recommendations as the modalities most likely to assist them in caring for survivors.


Most family physicians are willing to care for childhood cancer survivors in consultation with a cancer center, and with specific tools to facilitate this care.

Implications for Cancer Survivors

Adult and adolescent survivors of childhood cancer who receive their follow-up care from a family physician must be empowered to choose a physician who is comfortable with caring for survivors. Further, the survivor must ensure that their physician has access to a treatment summary as well as to patient-specific recommendations for surveillance for late effects of cancer therapy.


Cancer Pediatric Survivors Primary care Long-term care Delivery of health care Family physician 



Paul Nathan and Tara Henderson gratefully acknowledge the Pediatric Oncology Group of Ontario and the National Cancer Institute, respectively, for the funding.

Conflict of interest

None of the authors have any potential, perceived or real conflicts of interest.


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Copyright information

© Springer Science+Business Media New York 2013

Authors and Affiliations

  • Paul Craig Nathan
    • 1
    • 8
  • Christopher Keller Daugherty
    • 2
  • Kristen Elizabeth Wroblewski
    • 3
  • Mackenzie Louise Kigin
    • 2
  • Tom Vernon Stewart
    • 4
  • Fay Jarmila Hlubocky
    • 2
  • Eva Grunfeld
    • 5
  • Marie Elisabeth Del Giudice
    • 6
  • Leigh-Anne Evelyn Ward
    • 1
  • James Mahlon Galliher
    • 4
  • Kevin Charles Oeffinger
    • 7
  • Tara Olive Henderson
    • 2
  1. 1.The Hospital for Sick ChildrenTorontoCanada
  2. 2.Pritzker School of MedicineUniversity of ChicagoChicagoUSA
  3. 3.University of Chicago, Department of Health StudiesChicagoUSA
  4. 4.American Academy of Family Physicians (AAFP) Research NetworkLeawoodUSA
  5. 5.Ontario Institute for Cancer ResearchUniversity of TorontoTorontoCanada
  6. 6.Sunnybrook Health Sciences CentreTorontoCanada
  7. 7.Memorial Sloan–Kettering Cancer CenterNew YorkUSA
  8. 8.Department of PediatricsUniversity of TorontoTorontoCanada

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