Follow-Up Care for Breast and Colorectal Cancer Across the Globe: Survey Findings From 27 Countries
Michelle Mollica, Deborah K. Mayer, Kevin C. Oeffinger, Youngmee Kim, Susan S. Buckenmaier, Sudha Sivaram, Catherine Muha, Nur Aishah Mohd Taib, Elisabeth Andritsch, Chioma Asuzu, Ovidiu Vasile Bochis, Sheila Diaz, María Die Trill, Patricia García, Luigi Grassi, Yosuke Uchitomi, Asim Jamal Shaikh, Michael Jefford, Hyun Jeong Lee, Christoffer Johansen, Emmanuel Luyirika, Elizabeth Maher, Maria Madeline B. Mallillin, Theoneste Maniragaba, Anja Mehnert, C.S. Pramesh, Sabine Siesling, Orit Spira, Jonathan Sussman, Lili Tang, Nguyen Van Hai, Şuayib Yalçın, Paul B. Jacobsen
Abstract
PURPOSE: The purpose of this study was to describe follow-up care for breast and colorectal cancer survivors in countries with varying levels of resources and highlight challenges regarding posttreatment survivorship care. METHODS: We surveyed one key stakeholder from each of 27 countries with expertise in survivorship care on questions including the components/structure of follow-up care, delivery of treatment summaries and survivorship care plans, and involvement of primary care in survivorship. Descriptive analyses were performed to characterize results across countries and variations between the WHO income categories (low, middle, high). We also performed a qualitative content analysis of narratives related to survivorship care challenges to identify major themes. RESULTS: Seven low- or /lower-middle-income countries (LIC/LMIC), seven upper-middle-income countries (UMIC), and 13 high-income countries (HICs) were included in this study. Results indicate that 44.4% of countries with a National Cancer Control Plan currently address survivorship care. Additional findings indicate that HICs use guidelines more often than those in LICs/LMICs and UMICs. There was great variation among countries regardless of income level. Common challenges include issues with workforce, communication and care coordination, distance/transportation issues, psychosocial support, and lack of focus on follow-up care. CONCLUSION: This information can guide researchers, providers, and policy makers in efforts to improve the quality of survivorship care on a national and global basis. As the number of cancer survivors increases globally, countries will need to prioritize their long-term needs. Future efforts should focus on efforts to bridge oncology and primary care, building international partnerships, and implementation of guidelines.