Equitably improving outcomes for cancer survivors and supporting caregivers: A blueprint for care delivery, research, education, and policy

Alfano, Catherine M.; Leach, Corinne R.; Smith, Tenbroeck G.; Miller, Kim D.; Alcaraz, Kassandra I.; Cannady, Rachel S.; Wender, Richard C.; Brawley, Otis W.

doi:10.3322/caac.21548

Cited by 179Cancer survivorship and careChildhood Cancer Survivors' Quality of LifeEconomic and Financial Impacts of Cancer

Equitably improving outcomes for cancer survivors and supporting caregivers: A blueprint for care delivery, research, education, and policy

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Alfano, Catherine M., Leach, Corinne R., Smith, Tenbroeck G., Miller, Kim D., Alcaraz, Kassandra I., Cannady, Rachel S., Wender, Richard C., Brawley, Otis W.·2019·CA: A Cancer Journal for Clinicians

DOI 10.3322/caac.21548

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Abstract

Cancer care delivery is being shaped by growing numbers of cancer survivors coupled with provider shortages, rising costs of primary treatment and follow‐up care, significant survivorship health disparities, increased reliance on informal caregivers, and the transition to value‐based care. These factors create a compelling need to provide coordinated, comprehensive, personalized care for cancer survivors in ways that meet survivors’ and caregivers’ unique needs while minimizing the impact of provider shortages and controlling costs for health care systems, survivors, and families. The authors reviewed research identifying and addressing the needs of cancer survivors and caregivers and used this synthesis to create a set of critical priorities for care delivery, research, education, and policy to equitably improve survivor outcomes and support caregivers. Efforts are needed in 3 priority areas: 1) implementing routine assessment of survivors’ needs and functioning and caregivers’ needs; 2) facilitating personalized, tailored, information and referrals from diagnosis onward for both survivors and caregivers, shifting services from point of care to point of need wherever possible; and 3) disseminating and supporting the implementation of new care methods and interventions.

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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 [16]

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Authors: Alfano, C. M., Leach, C. R., Smith, T. G., Miller, K. D., Alcaraz, K. I., Cannady, R. S., Wender, R. C., & Brawley, O. W.
Affiliations: American Cancer Society (US)
Corresponding author: Alfano, Catherine M.
ORCID: Alfano, Catherine M.
Leach, Corinne R.
Smith, Tenbroeck G.
Alcaraz, Kassandra I.
Wender, Richard C.
Brawley, Otis W.
Venue: CA: A Cancer Journal for Clinicians
Publisher: Wiley
Published: 2018-10-30
Volume: 69
Issue: 1
Pages: 35-49
ISSN: 0007-9235 (ISSN-L)
1542-4863
DOI: 10.3322/caac.21548
OpenAlex: W2899383156
Cited by: 179
References: 120
Citations by year: 2026: 11 · 2025: 20 · 2024: 23 · 2023: 30 · 2022: 20 · 2021: 27 · 2020: 30 · 2019: 16 · 2018: 1 · 2013: 1
FWCI: 6.94
Type: journal article
Language: en
Open access: gold
doi.org
Licence: onlinelibrary.wiley.com/termsAndConditions#vor (vor)
Locations: CA A Cancer Journal for Clinicians (publishedVersion)
PubMed (publishedVersion)
Topics: Health Sciences › Medicine › Oncology › Cancer survivorship and care
Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Childhood Cancer Survivors' Quality of Life
Social Sciences › Economics, Econometrics and Finance › Economics and Econometrics › Economic and Financial Impacts of Cancer
Keywords: cancer survivors, informal caregivers, survivorship care, health care delivery, health disparities, provider shortages, value-based care, needs assessment, individualized care, care coordination, health policy, intervention implementation, health education
MeSH terms: Cancer Survivors, Adolescent, Adult, Aged, Aged, 80 and over, Child, Child, Preschool, Female, Health Policy, Health Services Accessibility, Humans, Infant, Infant, Newborn, Male, Medically Underserved Area, Middle Aged, Outcome and Process Assessment, Health Care, Referral and Consultation, Social Support, United States, Caregivers, Patient-Centered Care, Evidence-Based Medicine, Needs Assessment, Biomedical Research, Health Status Disparities, Healthcare Disparities, Young Adult, Quality Improvement

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Equitably improving outcomes for cancer survivors and supporting caregivers: A blueprint for care delivery, research, education, and policy

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