Cancer survivorship
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Cancer Survivorship: Health Care Use, Care Plans, and Emerging Models
Increasing Cancer Survivorship Rates
Advancements in cancer treatment and early detection have significantly increased the number of cancer survivors. As of January 1, 2022, over 18 million Americans were living with a history of cancer, a number projected to rise due to the aging population and improved survival rates . This growing population underscores the need for comprehensive survivorship care that addresses both medical and psychosocial needs .
Health Care Utilization in Cancer Survivorship
Cancer survivors have unique and ongoing health care needs that extend beyond the initial treatment phase. Studies indicate that over 90% of cancer survivors visit a primary care provider annually, highlighting the critical role of primary care in survivorship. Additionally, visits to oncologists and other specialists are associated with better cancer screening rates and quality care for non-cancer-related conditions. Effective survivorship care models emphasize high care density and low fragmentation between specialties, which can reduce costs and prevent redundant health care utilization.
Survivorship Care Plans (SCPs)
Survivorship Care Plans (SCPs) are recommended to help manage the long-term health of cancer survivors. SCPs typically include a treatment summary and follow-up care plans. However, evidence on the effectiveness of SCPs in improving health outcomes is mixed. While SCPs may enhance satisfaction with care and information received, they do not significantly impact physical, functional, or psychological well-being . The variability in SCP implementation and study designs may contribute to these inconclusive results . Future research should focus on ensuring SCP recommendations are acted upon and integrated into ongoing care.
Primary vs. Secondary Care in Survivorship
The role of primary care in cancer survivorship is increasingly recognized. Studies comparing primary and secondary care for cancer survivors show no significant differences in clinical and patient-reported outcomes, although primary care is associated with lower societal costs. This suggests that primary care can effectively manage survivorship care, provided there is adequate support and coordination with oncology specialists.
Virtual Care Models
Virtual care models are emerging as a sustainable solution to support cancer survivors. These models utilize web platforms, telephone calls, and mobile applications to deliver care, particularly for breast and prostate cancer survivors. Virtual care can increase health system capacity and improve survivorship outcomes by integrating with existing health services and involving a variety of healthcare professionals. Future innovations should focus on engaging diverse communities and repurposing common technologies to enhance accessibility and effectiveness.
Conclusion
The increasing number of cancer survivors necessitates robust and adaptable survivorship care models. Primary care plays a pivotal role in ongoing health management, and SCPs, despite mixed evidence, remain a valuable tool for structured follow-up. Virtual care models offer promising avenues to meet the growing demand for survivorship care. Continued research and innovation are essential to optimize care delivery and address the complex needs of cancer survivors.
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