While patients, PCPs, and oncologists largely agreed on which physician should handle comorbidity management, general preventive care, and follow-up mammograms during survivorship, there was notable disagreement in preferences for who should screen for other cancers, primarily between PCPs and oncologists.
Prior research suggests that oncologists lack trust in PCPs’ ability to deliver survivorship care, which may prompt them to provide the service themselves.3 Surprisingly, we found that more than half of PCPs in this sample preferred that oncologists screen for other cancers, a service routinely provided in primary care. PCPs have reported a lack of education and training in survivorship care, which may contribute to their reluctance to deliver screening services for breast cancer survivors.6 It is also possible that PCPs perceive that patients with a history of breast cancer are at higher risk for subsequent cancers and therefore warrant oncology involvement in these services.
Our results suggest that clarifying physician roles during breast cancer survivorship is necessary both between patients and physicians, but also among physicians themselves. Clinical guidelines and policy provisions that better delineate PCP and oncologist roles may be necessary to promote the delivery of effective team-based survivorship care.