From Department of Family and Community Medicine, UT Southwestern Medical Center, Dallas, Texas (IMX); University of New Mexico School of Medicine, Albuquerque, New Mexico and Board Member, Accreditation Council for Continuing Medical Education, Chicago, Illinois (WFR).
J Am Board Fam Med. 2022 Jul-Aug;35(4):708-715. doi: 10.3122/jabfm.2022.04.210445.
A rising population of cancer survivors is accompanied by a shortage of oncologists for continuity of care. This study examined the physicians who provided most of the care for cancer survivors, along with written information provided to the survivors before transfer of care.
Data were collected through the CDC-sponsored Behavioral Risk Factor Surveillance System. Our analysis involved states whose respondents completed a cancer survivorship module from 2016 to 2020. Primary measures were the proportions of physician specialists who provided most of their subsequent health care and the proportions of survivors who received written summaries of their care and instructions.
The 36,737 cancer survivor respondents came from 33 states. Most of their health care came from primary care physicians [family physicians (42.3%, 95% CI: 41.3-43.2%) and general internists (26.0%, 95% CI: 25.2-26.9%)]. When seen by primary care physicians rather than subspecialists, a lower proportion of patients recalled receiving summaries of either their cancer treatments (44.3%, 95% CI: 42.5 to 46.2 vs 50.5%, 95% CI: 49.4 to 51.7%) or follow-up instructions (69.9%, 95% CI: 68.8 to 71.0% vs 78.7%, 95%CI 77.1 to 80.2%), regardless of their cancer type.
Regardless of their cancer type, two-thirds of survivors received most of their health care from primary care physicians. Collaborative community-based care within a shared decision-making framework is essential to prioritize and individualize patients' understandings and needs in this growing population.
癌症幸存者人数不断增加，但能够提供连续性治疗的肿瘤学家却不足。本研究调查了为癌症幸存者提供大部分治疗的医生，以及在转移治疗前为幸存者提供的书面信息。
数据来自疾病预防控制中心（CDC）赞助的行为风险因素监测系统。我们的分析涉及到 2016 年至 2020 年期间完成癌症生存者模块的州。主要措施是提供大部分后续医疗服务的医师专家比例，以及接受护理总结和指导的幸存者比例。
36737 名癌症幸存者受访者来自 33 个州。他们的大部分医疗服务来自初级保健医生（家庭医生[42.3%（95%置信区间：41.3-43.2%）]和普通内科医生[26.0%（95%置信区间：25.2-26.9%）]）。当由初级保健医生而不是专科医生就诊时，接受癌症治疗总结或后续医嘱的患者比例较低（44.3%（95%置信区间：42.5-46.2%）与 50.5%（95%置信区间：49.4-51.7%），69.9%（95%置信区间：68.8-71.0%）与 78.7%（95%置信区间：77.1-80.2%），无论其癌症类型如何。
无论癌症类型如何，三分之二的幸存者主要从初级保健医生那里获得医疗服务。在以共同决策为框架的协作社区护理中，必须优先考虑并个性化患者在这一不断增长的人群中的理解和需求。
