The Cancer Survivorship Journey: Models of Care, Disparities, Barriers, and Future Directions
Open accessAbstract
Although the number of long-term cancer survivors has increased substantially over past years, the journey of survivorship does not always include high-quality, patient-centered care. A variety of survivorship care models have evolved based on who provides this care, the survivor population, the site of care, and/or the capacity for delivering specific services. Other areas of survivorship care being explored include how long follow-up care is needed, application of a risk-based approach to survivorship care, and the role of the survivor in his or her own recovery. However, there is little evidence indicating whether any models improve clinical or patient-reported outcomes. A newer focus in survivorship care has included assessment of potential disparities; the sociodemographic characteristics of population subgroups associated with barriers to receiving high-quality cancer treatment may also affect the survivorship period. Developing policies and programs to address disparities in survivorship care is not simple, and examining how financial hardship affects cancer outcomes, reducing economic barriers to care, and increasing incorporation of patient-centered strategies may be important components. Here too, there is little evidence regarding the best strategies to address these disparities. Barriers to providing high-quality, patient-centered survivorship care include lack of evidence, lack of a trained survivorship workforce, lack of reimbursement structures/insurance coverage, and lack of a health care system that reduces fragmented care. Future research needs to focus on developing a survivorship care evidence base, exploring strategies to facilitate provision of survivorship care, and disseminating best survivorship care practices to diverse and international audiences.
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Needs- and risk-adapted follow-up care is recommended after completion of primary treatment within the framework of the German guideline and Cancer Survivorship Programmes.
“Within the framework of the German guideline of diagnosis and care of breast cancer (“AWMF S3 Leitlinie”) and the development of Cancer Survivorship Programmes, a needs- and risk-adapted follow-up care is recommended after completion of primary treatment [15–17].”
The feasibility of these concepts depends heavily on the local healthcare system, financial constraints, patient population, and practitioners.
“The feasibility of these concepts depends heavily on the local healthcare system, financial constraints, patient population, and practitioners [16, 17].”
Current research on cancer follow-up care highlights the need of developing an evidence base for survivorship strategies and studying their implementation, both in terms of technical training and financing.
“In summary, current research on cancer follow-up care highlights the need of developing an evidence base for survivorship strategies and studying their implementation, both in terms of technical training and financing [16].”
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- Authors
- Halpern, M. T., McCabe, M. S., & Burg, M. A.
- Affiliations
- University of Central Florida (US)
- Venue
- American Society of Clinical Oncology Educational Book
- Published
- 2016-05
- Volume
- 36
- Issue
- 36
- Pages
- 231-239
- ISSN
- 1548-8748 (ISSN-L)
- 1548-8756
- OpenAlex
- W4254463786
- Cited by
- 103
- References
- 47
- Citations by year
- 2026: 11 · 2025: 9 · 2024: 16 · 2023: 22 · 2022: 11 · 2021: 10 · 2020: 10 · 2019: 7 · 2018: 2 · 2017: 4 · 2016: 1
- FWCI
- 2.51
- Type
- journal article
- Language
- en
- Open access
- Locations
- American Society of Clinical Oncology Educational Book (publishedVersion)
- PubMed (publishedVersion)
- Journal of International Crisis and Risk Communication Research (submittedVersion)
- Funders
- Partenariat Canadien Contre Le Cancer
- Topics
- Health Sciences › Medicine › Oncology › Cancer survivorship and care
- Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Childhood Cancer Survivors' Quality of Life
- Health Sciences › Medicine › Oncology › Global Cancer Incidence and Screening
- Keywords
- cancer survivorship, survivorship care models, health disparities, barriers to care, patient-centered care, financial hardship, insurance coverage, reimbursement structures, care fragmentation, sociodemographic disparities
- MeSH terms
- Delivery of Health Care, Humans, Neoplasms, Surveys and Questionnaires, Survivors, Patient-Centered Care
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