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Models of care for post-treatment follow-up of adult cancer survivors: a systematic review and quality appraisal of the evidence

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Abstract

Purpose

The impact of cancer and cancer treatment on the long-term health and quality of life of survivors is substantial, leading to questions about the most appropriate configuration of services and models of care for follow-up of post-primary treatment survivors.

Methods

A systematic review and quality appraisal of the health literature for structure of services and models of follow-up care for post-treatment survivors was identified through a search of guideline sources and empirical databases including MEDLINE, EMBASE, PsycINFO, the Cochrane Library, CINAHL, and EBSCO from 1999 through December 2009.

Results

Ten practice guidelines and nine randomized controlled trials comprised the evidence base for models of care for adult cancer survivors. Although the evidence base was rated as low quality, nurse-led and primary care physician models of follow-up care were equivalent for detecting recurrence. Consensus also suggests that cancer survivors may benefit from coordinated transition planning that includes the provision of survivorship care plans as part of standard care.

Conclusions

Realignment of models of care is identified as a health system priority to meet the supportive care and surveillance needs of a burgeoning survivor population. Further research is needed to evaluate the efficacy of models of care in a broader population of cancer survivors with differing needs and risks. While the evidence is limited, there is research that may be used to guide the configuration of health care services and planning.

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Acknowledgments

The survivorship expert panel would like to thank Ms. Sandra Costa for her assistance in the preparation of the manuscript. We thank Fay Bennie for her administrative support and Margaret Thompson who provided her insights as a cancer survivor and advocate, and expert in adult education. The systematic review evidence informed development of a guideline made possible through a grant from Health Canada, through the Canadian Partnership Against Cancer.

Conflict of interest

Each author completed conflict of interest forms, and forms were centrally collected and filed. None of the authors declared any real or perceived potential conflicts of interest associated with this systematic review of the evidence.

Editorial independence

The authors are editorially independent of any funding sources. The views and interests of the funding sources have not influenced the conclusions derived in this document.

Author information

Authors and Affiliations

  1. Faculty of Nursing, University Health Network, Toronto, ON, Canada

    S. Mayo

  2. Faculty of Nursing, University of Manitoba, Winnipeg, MB, Canada

    T. F. Hack

  3. Patient and Family Support Services, Cancer Care Manitoba, Winnipeg, MB, Canada

    T. F. Hack

  4. Department of Oncology, McMaster University, Hamilton, ON, Canada

    T. K. Oliver

  5. Nutrition Sciences, ParticipACTION, Toronto, ON, Canada

    T. Chulak

  6. Department of Family Medicine and Emergency Medicine, Université Laval, Quebec, QC, Canada

    M. Aubin

  7. Palliative Care Program, University of Ottawa, Ottawa, ON, Canada

    M. Chasen

  8. Palliative Rehabilitation and Survivorship, Elisabeth Bruyere Research Institute and Ottawa Regional Cancer Foundation, Ottawa, ON, Canada

    M. Chasen

  9. Health Services Research Program, Cancer Care Ontario and the Ontario Institute for Cancer Research, Toronto, ON, Canada

    C. C. Earle

  10. Cancer Patient Education and Survivorship, University Health Network, Toronto, ON, Canada

    A. J. Friedman

  11. Cancer Care Ontario, Toronto, ON, Canada

    A. J. Friedman & E. Green

  12. Peel Regional Oncology Programme, Credit Valley Hospital, Mississauga, ON, Canada

    G. W. Jones

  13. Department of Radiation Oncology, University of Toronto, Toronto, ON, Canada

    G. W. Jones

  14. Department of Psychiatry, Cancer Survivorship Program, University Health Network, University of Toronto, Toronto, ON, Canada

    J. M. Jones

  15. Patient and Family Counselling Services, BC Cancer Agency, Vancouver, BC, Canada

    M. Parkinson

  16. Patient and Family Counselling Services, BC Cancer Agency, Victoria, BC, Canada

    N. Payeur

  17. Department of Kinesiology and Physical Education, McGill University, Montreal, QC, Canada

    C. M. Sabiston

  18. Manitoba Palliative Care Research Unit, University of Manitoba, Winnipeg, MB, Canada

    S. Sinclair

  19. Faculty of Medicine, Calgary, Alberta, and Spiritual Care Services, Alberta Health Services, Tom Baker Cancer Centre, University of Calgary, Calgary, AB, Canada

    S. Sinclair

  20. Faculty of Nursing, University Health Network (Princess Margaret Hospital), 610 University Ave, Toronto, ON, Canada

    D. Howell

  21. Psychosocial Oncology and Palliative Care, Ontario Cancer Institute, 610 University Ave, Toronto, ON, Canada

    D. Howell

  22. Lawrence Bloomberg Faculty of Nursing, University of Toronto, 610 University Ave, Toronto, ON, Canada

    D. Howell

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  1. D. Howell
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  2. T. F. Hack
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  3. T. K. Oliver
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  5. S. Mayo
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Correspondence to D. Howell.

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Howell, D., Hack, T.F., Oliver, T.K. et al. Models of care for post-treatment follow-up of adult cancer survivors: a systematic review and quality appraisal of the evidence. J Cancer Surviv 6, 359–371 (2012). https://doi.org/10.1007/s11764-012-0232-z

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  • DOI: https://doi.org/10.1007/s11764-012-0232-z

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