Survivorship care for cancer patients in primary versus secondary care: a systematic review.

Content Provider	Europe PMC
Author	Vos, J. A. M. Wieldraaijer, T. van Weert, H. C. P. M. van Asselt, K. M.
Abstract	BackgroundCancer survivorship care is traditionally performed in secondary care. Primary care is often involved in cancer management and could therefore play a more prominent role.PurposeTo assess outcomes of cancer survivorship care in primary versus secondary care.MethodsA systematic search of MEDLINE and EMBASE was performed. All original studies on cancer survivorship care in primary versus secondary care were included. A narrative synthesis was used for three distinctive outcomes: (1) clinical, (2) patient-reported, and (3) costs.ResultsSixteen studies were included: 7 randomized trials and 9 observational studies. Meta-analyses were not feasible due to heterogeneity. Most studies reported on solid tumors, like breast (N = 7) and colorectal cancers (N = 3). Clinical outcomes were reported by 10 studies, patient-reported by 11, and costs by 4. No important differences were found on clinical and patient-reported outcomes when comparing primary- with secondary-based care. Some differences were seen relating to the content and quality of survivorship care, such as guideline adherence and follow-up tests, but there was no favorite strategy. Survivorship care in primary care was associated with lower societal costs.ConclusionsOverall, cancer survivorship care in primary care had similar effects on clinical and patient-reported outcomes compared with secondary care, while resulting in lower costs.Implications for cancer survivorsSurvivorship care in primary care seems feasible. However, since the design and outcomes of studies differed, conclusive evidence for the equivalence of survivorship care in primary care is still lacking. Ongoing studies will help provide better insights.
Related Links	https://europepmc.org/backend/ptpmcrender.fcgi?accid=PMC7822798&blobtype=pdf
ISSN	19322259
Journal	Journal of Cancer Survivorship [J Cancer Surviv]
Volume Number	15
DOI	10.1007/s11764-020-00911-w
PubMed Central reference number	PMC7822798
Issue Number	1
PubMed reference number	32815087
e-ISSN	19322267
Language	English
Publisher	Springer US
Publisher Date	2020-08-19
Publisher Place	New York
Access Restriction	Open
Rights License	Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. © The Author(s) 2020
Subject Keyword	Cancer survivorship care Primary care Secondary care Systematic review
Content Type	Text
Resource Type	Article
Subject	Oncology (nursing) Oncology