Survivorship care and late-effects surveillance
Organised follow-up for the 18 million US and 50+ million global cancer survivors: watching for recurrence and second cancers, managing long-term side effects such as heart damage, infertility, neuropathy and fatigue, and helping people return to work and life.
The IOM report 'From Cancer Patient to Cancer Survivor: Lost in Transition' (2006) launched survivorship as a phase of care and recommended a written survivorship care plan (SCP). Trials of SCPs alone showed little benefit (Grunfeld 2011), and the ACoS dropped the SCP mandate in 2020 in favour of comprehensive survivorship programmes. Core content: risk-based surveillance (COG Long-Term Follow-Up Guidelines for childhood cancer survivors, who have >95% cumulative chronic-condition incidence by age 50, St Jude Lifetime Cohort), cardio-oncology, endocrine and fertility issues, second primary cancers, neurocognitive effects, fatigue, sexual health, psychosocial and employment support, and health promotion. Delivery models: oncologist-led, nurse-led, shared care with primary care, and risk-stratified pathways (NHS personalised stratified follow-up). Adolescent and young adult survivors and rural/minority survivors have the largest gaps.
How it works
Risk-stratified, guideline-based lifelong surveillance and management of late effects, with explicit transfer of information and responsibility between oncology and primary care, and attention to the whole person (work, finances, relationships).
- Evidence-based screening prevents or detects late effects (e.g. breast MRI after chest radiation)
- Nurse-led and primary-care models are as safe as specialist follow-up for low-risk survivors
- Childhood survivor guidelines are mature and international (IGHG)
- Care plans alone do not change outcomes
- Fragmentation between oncology and primary care
- Adult late-effects guidelines less developed than paediatric
Latest papers
topQuery for this technology: (TITLE:"Survivorship care and late-effects surveillance" OR ABSTRACT:"Survivorship care and late-effects surveillance") AND (cancer OR tumor OR tumour OR oncology OR carcinoma OR lymphoma OR leukemia OR leukaemia OR myeloma OR sarcoma OR melanoma OR glioma). Results are unfiltered search hits about Survivorship care and late-effects surveillance, not a curated reading list.