Journal of Cancer Survivorship

, Volume 8, Issue 2, pp 229–238 | Cite as

Perspectives of cancer survivors on the role of different healthcare providers in an integrated delivery system

  • Jessica Chubak
  • Erin J. Aiello Bowles
  • Leah Tuzzio
  • Evette Ludman
  • Carolyn M. Rutter
  • Robert J. Reid
  • Edward H. Wagner



The purpose of this paper is to describe patient perspectives on survivorship care 1 year after cancer diagnosis.


The study was conducted at an integrated healthcare delivery system in western Washington State. Participants were patients with breast, colorectal, and lung cancer who had enrolled in a randomized control trial (RCT) of oncology nurse navigation to improve early cancer care. Those alive and enrolled in the healthcare system 1 year after diagnosis were eligible for this analysis. Participants completed surveys by phone. Questions focused on receipt of treatment summaries and care plans; discussions with different providers; patient opinions on who does and should provide their care; and patient perspectives primary care providers’ (PCP) knowledge and skills related to caring for cancer survivors


Of the 251 participants in the RCT, 230 (91.6 %) responded to the 12-month phone survey and were included in this analysis; most (n = 183, 79.6 %) had breast cancer. The majority (84.8 %) considered their cancer specialist (e.g., medical, radiation, surgical or gynecological oncologist) to be their main provider for cancer follow-up and most (69.4 %) had discussed follow-up care with that provider. Approximately half of patients were uncertain how well their PCP communicated with the oncologist and how knowledgeable s/he was in caring for cancer survivors.


One year after diagnosis, cancer survivors continue to view cancer specialists as their main providers and are uncertain about their PCP’s skills and knowledge in managing their care. Our findings present an opportunity to help patients understand what their PCPs can and cannot provide in the way of cancer follow-up care.

Implications for cancer survivors

Additional research on care coordination and delivery is necessary to help cancer survivors manage their care between primary care and specialty providers.


Cancer survivorship Shared care Navigation Primary care 



The authors thank the nurse navigators: Ellen Canfield, Lynn Flaherty, and Jennifer Min; and Kathryn Horner, Ruth McCorkle PhD, and Eric Chen MD for their leadership in developing the project and supporting the intervention; and Beth Kirlin and Janice Miyoshi for their administrative and data collection support.


This work was supported by the National Cancer Institute of the National Institutes of Health (grant number P20CA137219 to EHW). The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. The collection of cancer stage data used in this study was supported by the Cancer Surveillance System of the Fred Hutchinson Cancer Research Center, which is funded by Contract No. N01-CN-67009 and N01-PC-35142 from the Surveillance, Epidemiology and End Results (SEER) Program of the National Cancer Institute with additional support from the Fred Hutchinson Cancer Research Center and the State of Washington.


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Copyright information

© Springer Science+Business Media New York 2013

Authors and Affiliations

  • Jessica Chubak
    • 1
    • 2
  • Erin J. Aiello Bowles
    • 1
  • Leah Tuzzio
    • 1
  • Evette Ludman
    • 1
  • Carolyn M. Rutter
    • 1
    • 3
    • 4
  • Robert J. Reid
    • 1
    • 4
  • Edward H. Wagner
    • 1
  1. 1.Group Health Research InstituteSeattleUSA
  2. 2.Department of EpidemiologyUniversity of WashingtonSeattleUSA
  3. 3.Department of BiostatisticsUniversity of WashingtonSeattleUSA
  4. 4.Department of Health ServicesUniversity of WashingtonSeattleUSA

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