Follow-up patterns of cancer survivors: a survey of Canadian radiation oncologists.

PURPOSE: With continual advancements in cancer care, improved outcomes, and increasing survivors, survivorship has become an important area of research. This project seeks to determine the current status of follow-up care in oncology.

METHODS: An electronic survey was sent to the Canadian Association of Radiation Oncology members. Based on brief clinical scenarios pertaining to various survivor populations, questions were posed to determine routine follow-up practices.

RESULTS: One hundred eleven radiation oncologists (RO) responded (44% response rate); 29% were female, 43% were in practice <10 years, and most of Canada was represented. Most worked in centers with >10 oncologists (69%) and saw >200 new consults per year (78%). Only 10% reported not following their patients routinely, mainly in those with breast cancer. Most would follow their central nervous system, gastrointestinal, head and neck, gynecologic, and genitourinary patients. Lack of resources and a belief that follow-up by family physicians (FPs) is equally effective were the top reasons for not following. Treatment toxicity and possibility of further treatment were the most common reasons for routine follow-up. The majority (55%) would follow patients for <5 years, with 36% for 5-10 years, and a minority (9%) for longer than 10 years; 54% would not change the frequency of follow-up, but 39% would decrease and only 7% would increase follow-up. Some felt transferring more care to other health professionals would require additional training and more guidelines. Survivorship care plans are underutilized.

CONCLUSIONS: Transfer of follow-up care to FPs is desired and feasible. This would allow for more comprehensive medical care and improve access to care for newly diagnosed patients. The development and usage of survivorship care plans would improve this care.

IMPLICATIONS FOR CANCER SURVIVORS: Survivors may be increasingly followed by family physicians. Better coordination between oncologists and family physicians, including the use of survivorship care plans, may facilitate this transition.