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Overview of cancer survivorship care for primary care and oncology providers

Authors
Larissa Nekhlyudov, MD, MPH
Claire Snyder, PhD
Section Editor
Patricia A Ganz, MD
Deputy Editor
Sadhna R Vora, MD

INTRODUCTION

The term "cancer survivor" has been used variably in the literature; most commonly, a cancer survivor refers to any person who has been diagnosed with cancer. Therefore, survivorship begins at the time of diagnosis and includes the periods of initial treatment with intent to cure, cancer-free survival, chronic or intermittent disease, and palliative care [1].

There are now over 13 million cancer survivors in the United States [2] and close to 30 million survivors worldwide [3]. This number is expected to grow due to improvements in cancer screening [4], increases in life expectancy following definitive cancer treatment [2,4], and the aging of the population [5].

Many studies report that cancer survivors often do not receive the appropriate oncology and primary care services, with evidence of overuse [6-9] and underuse of services [6,7,9-15]. For cancer survivors who are no longer in active treatment, healthcare needs include surveillance for recurrence, screening for the development of secondary cancers, monitoring for the long-term and late physical and psychological effects of cancer and its treatment, management of comorbid medical conditions, as well as routine preventive and primary care. Unfortunately, there are few data available on how to best provide oncology and primary care in a coordinated and comprehensive fashion.

In this topic, we provide an overview of cancer survivorship care and address ways to enhance the care for cancer survivors. For this review, we will concentrate on the care of patients who have completed treatment with curative intent. A discussion on the phases of cancer survivorship and topics on cancer survivorship for patients with a specific diagnosis are addressed elsewhere. (See 'Cancer-specific information for survivors' below.)

EPIDEMIOLOGY OF CANCER SURVIVORS

The number of individuals diagnosed with cancer has increased dramatically from approximately 3 million in the 1970s to nearly 14.5 million in 2014 [2,16]. The majority of survivors were diagnosed more than five years ago with 36, 24, 16, and 25 percent diagnosed 0 to <5, 5 to <10, 10 to <15, and 15 or more years previously [16].

                  

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