Community care integration

The number of cancer survivors in the United States continues to grow and is approaching 14 million. Cancer survivorship care varies by disease type, but the primary components of care include surveillance for recurrence, screening for second primary cancers, and primary prevention involving lifestyle interventions and improving psychosocial functioning. The goal of survivorship care is to maximize disease-free survival while maintaining optimal quality of life. Optimal care can be provided by primary care physicians in addition to cancer specialists; however, delivery of high-quality care for cancer survivors can be hindered by poor coordination of care, limitations in knowledge and skills related to survivorship care, gaps in evidence-based recommendations for prevention and other areas of survivorship care beyond the first few years, and communication issues. Coordination of care and communication may be improved by the use of a “survivorship care plan” document that provides a concise summary of the patient’s treatment and a plan for follow-up care. In addition, variations across ethnic groups in the impact of cancer during the survivorship phase of care have been documented in several areas of study, and cultural, social, and ethnic considerations are important factors in delivering optimal care to cancer survivors.