Follow-Up Care for Breast and Colorectal Cancer Across the Globe: Survey Findings From 27 Countries

Michelle A. Mollica*, Deborah K. Mayer, Kevin C. Oeffinger, Youngmee Kim, Susan S. Buckenmaier, Sudha Sivaram, Catherine Muha, Nur Aishah Taib, Elisabeth Andritsch, Chioma C. Asuzu, Ovidiu V. Bochis, Sheila Diaz, Maria Die Trill, Patricia J. Garcia, Luigi Grassi, Yosuke Uchitomi, Asim Jamal Shaikh, Michael Jefford, Hyun Jeong Lee, Christoffer JohansenEmmanuel Luyirika, Elizabeth Jane Maher, Maria Madeline B. Mallillin, Theoneste Maniragaba, Anja Mehnert-Theuerkauf, C.S. Pramesh, Sabine Siesling, Orit Spira, Jonathan Sussman, Lili Tang, Nguyen V. Hai, Suayib Yalcin, Paul B. Jacobsen

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

11 Citations (Scopus)
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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.
Original languageEnglish
Pages (from-to)1394-1411
Number of pages18
JournalJCO Global Oncology
Issue number6
Publication statusPublished - 21 Sep 2020


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