Abstract
Traditionally, the role of primary care providers (pcps) across the cancer care trajectory has focused on prevention and early detection. In combination with screening initiatives, new and evolving treatment approaches have contributed to significant improvements in survival in a number of cancer types. For Canadian cancer survivors, the 5-year survival rate is now better than it was a decade ago, and the survivor population is expected to reach 2 million by 2031. Notwithstanding those improvements, many cancer survivors experience late and long-term effects, and comorbid conditions have been noted to be increasing in prevalence for this vulnerable population. In view of those observations, and considering the anticipated shortage of oncology providers, increasing reliance is being placed on the primary care workforce for the provision of survivorship care. Despite the willingness of pcps to engage in that role, further substantial efforts to elucidate the landscape of high-quality, sustainable, and comprehensive survivorship care delivery within primary care are required. The present article offers an overview of the integration of pcps into survivorship care provision. More specifically, it outlines known barriers and potential solutions in five categories: ■ Survivorship care coordination■ Knowledge of survivorship■ pcp-led clinical environments■ Models of survivorship care■ Health policy and organizational advocacy.
Highlights
The role of primary care providers across the cancer care trajectory has focused predominantly on prevention and early detection[1]
New treatment modalities have contributed to impressive achievements in oncology: the 5-year survival rate for cancer survivors is better than it was a decade ago, and the survivor population is expected to reach 2 million by 20312
In view of those observations, and considering the anticipated shortage of oncology providers[5], reliance is increasingly being placed on pcps for survivorship care provision[6]
Summary
The role of primary care providers (pcps) across the cancer care trajectory has focused predominantly on prevention and early detection[1]. Existing models for survivorship share one commonality: they include primary care professionals as key providers of survivorship care, reinforcing the importance of strategic interventions to optimize the integration of pcps into the follow-up care of cancer survivors (Figure 1). Given that pcps report the value of guidelines as tools in survivorship care provision[7], optimization of current guidelines to reflect high-quality evidence-based interventions in the primary care setting are warranted[6]. Endorsement of survivorship as a distinct clinical category, together with utilization of data from electronic medical records, could aid in such guideline optimization It could facilitate the creation of electronic medical record– based decision aids and reminders to guide pcps and promote a comprehensive approach to cancer survivors, which is important for survivors presenting with comorbid conditions[19]. All the foregoing actions are of paramount importance to optimize pcp-led survivorship care delivery[19]
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