"Although both oncologists and primary care doctors routinely recommended the use of several laboratory and imaging tests to detect cancer recurrence that are not part of guideline-directed care, more of the primary care physicians recommended these tests than did oncologists," Potosky says.
He says reasons for over-testing may include the practice of defensive medicine, reimbursement incentives for office-based lab testing, or uncertainty regarding best care practices. In some cases, such testing may also be influenced by survivors' requests.
The "Survey of Physicians Attitudes Regarding the Care of Cancer Survivors" asked both groups of doctors several questions about providing cancer survivorship care including the doctors' confidence in their knowledge about such care, and cancer surveillance practices.
In 2006, a report from the Institute of Medicine (IOM) recommended that patients completing primary treatment for cancer, and their primary care providers, be given a summary of their treatment and a comprehensive plan for follow-up.
Such a plan would inform patients (and their providers) of the long-term effects of cancer and its treatment, identify psychosocial support resources in their communities, and provide guidance on follow-up care, prevention, and health maintenance.
Julia Rowland, Ph.D., director of the Office of Cancer Survivorship at the National Cancer Institute and a co-author, says this study suggests several key insights regarding the implementation of the IOM's recommendations.
"More training and education on cancer survivorship is critical for the primary care physician and the oncologist," she says. "This might include identification of who may be best equipped to provide different aspects of care. Use of
|Contact: Karen Mallet|
Georgetown University Medical Center