Cancer Survivors Need Organized Preventive Care

By David Douglas

NEW YORK MAR 25, 2008 (Reuters Health) - As oncologists become less involved in the care of patients who have survived cancer, cancer-related screening decreases significantly, a study shows.

"Our results support the need for survivorship care plans as recommended by the Institute of Medicine," lead investigator Dr. Claire F. Snyder told Reuters Health. "These survivorship care plans should define the roles and responsibilities of primary care providers and oncology specialists and take into account that, over time, survivors may visit oncology specialists less often and rely solely on primary care providers more often."

As they report in the March 1st issue of the Journal of Clinical Oncology, Snyder of the Johns Hopkins School of Medicine, Baltimore, and colleagues reviewed the care received by more than 1,500 colorectal cancer survivors during the 5 years after active treatment ended.

Over this period, the average number of primary care physician visits rose significantly from 4.2 to 4.7 annually while oncology visits dropped from 1.3 to 0.5.

The researchers note that care by primary care physician only rose from 44 percent to 62 percent, whereas shared care by oncologists and primary care physicians fell significantly from 37 percent to 21 percent, respectively.

Although there was an increase in influenza screening, there also was a significant decrease in mammography and cervical cancer screening.

Survivors who saw both oncologists and primary care physicians were more likely to have influenza vaccination and mammography and cervical cancer screening. However, those who saw primary care physicians only were more likely to receive bone densitometry and cholesterol screening.

Snyder concluded, "Developing survivorship care plans with clearly delineated roles for primary care providers and oncology specialists can help ensure that quality care is provided in a coordinated and efficient manner."

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