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Physician Roles Unclear in Cancer Survivor Care

Divergent views of patients, oncologists and primary care physicians can lead to gaps or overlaps in follow-up care

FRIDAY, April 3 (HealthDay News) -- Cancer survivors, their oncologists and primary care physicians (PCPs) have divergent views of their respective roles in follow-up cancer screening and general health care, potentially leading to gaps or overlaps in care, according to a report published online March 30 in the Journal of Clinical Oncology.

Winson Y. Cheung, M.D., of Harvard School of Public Health in Boston, and colleagues separately surveyed 992 cancer survivors and 607 physicians (oncologists and PCPs) to determine their expectations for follow-up screening and general health care. Among those surveyed, 535 survivors and 378 physicians (255 PCPs and 123 oncologists) were assessable.

For the patient-oncologist pairs, there was a lack of agreement (agreement rate 29 percent) on follow-up screening for non-primary cancers with patients expecting more oncologist involvement, the investigators found. For the patient-PCP pairs there was a lack of agreement (35 percent agreement) on primary cancer screening with PCPs expecting to shoulder more responsibility than patients expected. The PCP-oncologist pairs had dramatic disagreement about their respective roles for the primary cancer follow-up (3 percent agreement), and lesser disagreements about cancer screening (44 percent agreement) and general preventive health (51 percent agreement), the report indicates.

"Understandably, many patients assume their oncologist will manage anything related to their original cancer diagnosis, including screening for other cancers. Our data suggest, however, that oncologists often do not see themselves in these roles. With a lack of clarity about which provider is responsible for care, patients may not receive necessary services of demonstrated benefit," the authors write.

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