Personalized Risk-Stratified Cancer Follow-Up Care: Its Potential for Healthier Survivors, Happier Clinicians, and Lower Costs
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The growth in the number of cancer survivors in the face of projected health-care workforce shortages will challenge the US health-care system in delivering follow-up care. New methods of delivering follow-up care are needed that address the ongoing needs of survivors without overwhelming already overflowing oncology clinics or shuttling all follow-up patients to primary care providers. One potential solution, proposed for over a decade, lies in adopting a personalized approach to care in which survivors are triaged or risk-stratified to distinct care pathways based on the complexity of their needs and the types of providers their care requires. Although other approaches may emerge, we advocate for development, testing, and implementation of a risk-stratified approach as a means to address this problem. This commentary reviews what is needed to shift to a risk-stratified approach in delivering survivorship care in the United States.
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Implementation challenges for comprehensive survivorship care include lack of health care professional awareness and training, prioritization of survivorship, organizational barriers such as dedicated time slots, multidisciplinary assessment, referral networks, and reimbursement issues.
“This may be related to implementation challenges such as lack of health care professional awareness and training and prioritization of survivorship, organizational barriers including the need for dedicated time slots in clinics to allow for multidisciplinary assessment and management involving a range of subspecialty professionals and supportive care experts, articulation with appropriate referral”
From Implementing a PROACTive Care Pathway to Empower and Support Survivors of Breast Cancer (2023) · cites this paper as [15]
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- Authors
- Mayer, D. K., & Alfano, C. M.
- Affiliations
- University of North Carolina at Chapel Hill (US)
- American Cancer Society (US)
- Corresponding author
- Mayer, Deborah K
- Venue
- JNCI: Journal of the National Cancer Institute
- Publisher
- Oxford University Press (OUP)
- Published
- 2019-02-06
- Volume
- 111
- Issue
- 5
- Pages
- 442-448
- ISSN
- 0027-8874 (ISSN-L)
- 1460-2105
- PMC
- PMC6804411
- OpenAlex
- W2913329666
- Cited by
- 127
- References
- 46
- Citations by year
- 2026: 18 · 2025: 18 · 2024: 8 · 2023: 13 · 2022: 19 · 2021: 25 · 2020: 14 · 2019: 11 · 2013: 1
- FWCI
- 1.31
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Licence
- academic.oup.com/journals/pages/open_access/funder_policies/chorus/standard_publication_model (vor)
- Locations
- JNCI Journal of the National Cancer Institute (publishedVersion)
- Europe PMC (PubMed Central) (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Funders
- NIH
- Topics
- Health Sciences › Medicine › Oncology › Cancer survivorship and care
- Health Sciences › Medicine › Oncology › Global Cancer Incidence and Screening
- Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Childhood Cancer Survivors' Quality of Life
- Keywords
- survivorship care, risk stratification, individualized care, triage, care pathways, health workforce shortage, cost reduction, clinician workload
- MeSH terms
- Cancer Survivors, Survivorship, Aftercare, Cost Control, Delivery of Health Care, Health Personnel, Health Status Indicators, Humans, Triage, United States, Critical Pathways, Needs Assessment, Precision Medicine
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