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<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">Use of physician services during the survivorship phase: a multi-province study of women diagnosed with breast cancer</title><author><name sortKey="Kendell, C" sort="Kendell, C" uniqKey="Kendell C" first="C." last="Kendell">C. Kendell</name><affiliation><nlm:aff id="af1-conc-24-81">Cancer Outcomes Research Program, Dalhousie University and Nova Scotia Health Authority, Halifax, NS;</nlm:aff></affiliation></author><author><name sortKey="Decker, K M" sort="Decker, K M" uniqKey="Decker K" first="K. M." last="Decker">K. M. Decker</name><affiliation><nlm:aff id="af2-conc-24-81">Department of Community Health Sciences, University of Manitoba, Winnipeg, MB;</nlm:aff></affiliation><affiliation><nlm:aff id="af3-conc-24-81">Epidemiology and Cancer Registry, Cancer-Care Manitoba, Winnipeg, MB;</nlm:aff></affiliation></author><author><name sortKey="Groome, P A" sort="Groome, P A" uniqKey="Groome P" first="P. A." last="Groome">P. A. Groome</name><affiliation><nlm:aff id="af4-conc-24-81">Division of Cancer Care and Epidemiology, Cancer Research Institute, Queen’s University, Kingston, ON;</nlm:aff></affiliation></author><author><name sortKey="Mcbride, M L" sort="Mcbride, M L" uniqKey="Mcbride M" first="M. L." last="Mcbride">M. L. Mcbride</name><affiliation><nlm:aff id="af5-conc-24-81">Cancer Control Research, BC Cancer Agency, Vancouver, BC;</nlm:aff></affiliation></author><author><name sortKey="Jiang, L" sort="Jiang, L" uniqKey="Jiang L" first="L." last="Jiang">L. Jiang</name><affiliation><nlm:aff id="af4-conc-24-81">Division of Cancer Care and Epidemiology, Cancer Research Institute, Queen’s University, Kingston, ON;</nlm:aff></affiliation></author><author><name sortKey="Krzyzanowska, M K" sort="Krzyzanowska, M K" uniqKey="Krzyzanowska M" first="M. K." last="Krzyzanowska">M. K. Krzyzanowska</name><affiliation><nlm:aff id="af6-conc-24-81">University Health Network, Toronto, ON;</nlm:aff></affiliation><affiliation><nlm:aff id="af7-conc-24-81">Cancer Care Ontario, Toronto, ON;</nlm:aff></affiliation></author><author><name sortKey="Porter, G" sort="Porter, G" uniqKey="Porter G" first="G." last="Porter">G. Porter</name><affiliation><nlm:aff id="af1-conc-24-81">Cancer Outcomes Research Program, Dalhousie University and Nova Scotia Health Authority, Halifax, NS;</nlm:aff></affiliation><affiliation><nlm:aff id="af8-conc-24-81">Department of Surgery, Dalhousie University, Halifax, NS;</nlm:aff></affiliation></author><author><name sortKey="Turner, D" sort="Turner, D" uniqKey="Turner D" first="D." last="Turner">D. Turner</name><affiliation><nlm:aff id="af3-conc-24-81">Epidemiology and Cancer Registry, Cancer-Care Manitoba, Winnipeg, MB;</nlm:aff></affiliation><affiliation><nlm:aff id="af9-conc-24-81">University of Manitoba, Winnipeg, MB;</nlm:aff></affiliation></author><author><name sortKey="Urquhart, R" sort="Urquhart, R" uniqKey="Urquhart R" first="R." last="Urquhart">R. Urquhart</name><affiliation><nlm:aff id="af1-conc-24-81">Cancer Outcomes Research Program, Dalhousie University and Nova Scotia Health Authority, Halifax, NS;</nlm:aff></affiliation><affiliation><nlm:aff id="af8-conc-24-81">Department of Surgery, Dalhousie University, Halifax, NS;</nlm:aff></affiliation></author><author><name sortKey="Winget, M" sort="Winget, M" uniqKey="Winget M" first="M." last="Winget">M. Winget</name><affiliation><nlm:aff id="af10-conc-24-81">Stanford University School of Medicine, Stanford, CA, U.S.A.;</nlm:aff></affiliation></author><author><name sortKey="Grunfeld, E" sort="Grunfeld, E" uniqKey="Grunfeld E" first="E." last="Grunfeld">E. Grunfeld</name><affiliation><nlm:aff id="af11-conc-24-81">Department of Family and Community Medicine, University of Toronto, Toronto, ON.</nlm:aff></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PMC</idno><idno type="pmid">28490921</idno><idno type="pmc">5407870</idno><idno type="url">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5407870</idno><idno type="RBID">PMC:5407870</idno><idno type="doi">10.3747/co.24.3454</idno><date when="2017">2017</date><idno type="wicri:Area/Pmc/Corpus">002D75</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Corpus" wicri:corpus="PMC">002D75</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">Use of physician services during the survivorship phase: a multi-province study of women diagnosed with breast cancer</title><author><name sortKey="Kendell, C" sort="Kendell, C" uniqKey="Kendell C" first="C." last="Kendell">C. Kendell</name><affiliation><nlm:aff id="af1-conc-24-81">Cancer Outcomes Research Program, Dalhousie University and Nova Scotia Health Authority, Halifax, NS;</nlm:aff></affiliation></author><author><name sortKey="Decker, K M" sort="Decker, K M" uniqKey="Decker K" first="K. M." last="Decker">K. M. Decker</name><affiliation><nlm:aff id="af2-conc-24-81">Department of Community Health Sciences, University of Manitoba, Winnipeg, MB;</nlm:aff></affiliation><affiliation><nlm:aff id="af3-conc-24-81">Epidemiology and Cancer Registry, Cancer-Care Manitoba, Winnipeg, MB;</nlm:aff></affiliation></author><author><name sortKey="Groome, P A" sort="Groome, P A" uniqKey="Groome P" first="P. A." last="Groome">P. A. Groome</name><affiliation><nlm:aff id="af4-conc-24-81">Division of Cancer Care and Epidemiology, Cancer Research Institute, Queen’s University, Kingston, ON;</nlm:aff></affiliation></author><author><name sortKey="Mcbride, M L" sort="Mcbride, M L" uniqKey="Mcbride M" first="M. L." last="Mcbride">M. L. Mcbride</name><affiliation><nlm:aff id="af5-conc-24-81">Cancer Control Research, BC Cancer Agency, Vancouver, BC;</nlm:aff></affiliation></author><author><name sortKey="Jiang, L" sort="Jiang, L" uniqKey="Jiang L" first="L." last="Jiang">L. Jiang</name><affiliation><nlm:aff id="af4-conc-24-81">Division of Cancer Care and Epidemiology, Cancer Research Institute, Queen’s University, Kingston, ON;</nlm:aff></affiliation></author><author><name sortKey="Krzyzanowska, M K" sort="Krzyzanowska, M K" uniqKey="Krzyzanowska M" first="M. K." last="Krzyzanowska">M. K. Krzyzanowska</name><affiliation><nlm:aff id="af6-conc-24-81">University Health Network, Toronto, ON;</nlm:aff></affiliation><affiliation><nlm:aff id="af7-conc-24-81">Cancer Care Ontario, Toronto, ON;</nlm:aff></affiliation></author><author><name sortKey="Porter, G" sort="Porter, G" uniqKey="Porter G" first="G." last="Porter">G. Porter</name><affiliation><nlm:aff id="af1-conc-24-81">Cancer Outcomes Research Program, Dalhousie University and Nova Scotia Health Authority, Halifax, NS;</nlm:aff></affiliation><affiliation><nlm:aff id="af8-conc-24-81">Department of Surgery, Dalhousie University, Halifax, NS;</nlm:aff></affiliation></author><author><name sortKey="Turner, D" sort="Turner, D" uniqKey="Turner D" first="D." last="Turner">D. Turner</name><affiliation><nlm:aff id="af3-conc-24-81">Epidemiology and Cancer Registry, Cancer-Care Manitoba, Winnipeg, MB;</nlm:aff></affiliation><affiliation><nlm:aff id="af9-conc-24-81">University of Manitoba, Winnipeg, MB;</nlm:aff></affiliation></author><author><name sortKey="Urquhart, R" sort="Urquhart, R" uniqKey="Urquhart R" first="R." last="Urquhart">R. Urquhart</name><affiliation><nlm:aff id="af1-conc-24-81">Cancer Outcomes Research Program, Dalhousie University and Nova Scotia Health Authority, Halifax, NS;</nlm:aff></affiliation><affiliation><nlm:aff id="af8-conc-24-81">Department of Surgery, Dalhousie University, Halifax, NS;</nlm:aff></affiliation></author><author><name sortKey="Winget, M" sort="Winget, M" uniqKey="Winget M" first="M." last="Winget">M. Winget</name><affiliation><nlm:aff id="af10-conc-24-81">Stanford University School of Medicine, Stanford, CA, U.S.A.;</nlm:aff></affiliation></author><author><name sortKey="Grunfeld, E" sort="Grunfeld, E" uniqKey="Grunfeld E" first="E." last="Grunfeld">E. Grunfeld</name><affiliation><nlm:aff id="af11-conc-24-81">Department of Family and Community Medicine, University of Toronto, Toronto, ON.</nlm:aff></affiliation></author></analytic><series><title level="j">Current Oncology</title><idno type="ISSN">1198-0052</idno><idno type="eISSN">1718-7729</idno><imprint><date when="2017">2017</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><sec><title>Introduction</title><p>Oncologists have traditionally been responsible for providing routine follow-up care for cancer survivors; in recent years, however, primary care providers (<sc>pcp</sc>s) are taking a greater role in care during the follow-up period. In the present study, we used a longitudinal multi-province retrospective cohort study to examine how primary care and specialist care intersect in the delivery of breast cancer follow-up care.</p></sec><sec><title>Methods</title><p>Various databases (registry, clinical, and administrative) were linked in each of four provinces: British Columbia, Manitoba, Ontario, and Nova Scotia. Population-based cohorts of breast cancer survivors were identified in each province. Physician visits were identified using billings or claims data and were classified as visits to primary care (total, breast cancer–specific, and other), oncology (medical oncology, radiation oncology, and surgery), and other specialties. The mean numbers of visits by physician type and specialty, or by combinations thereof, were examined. The mean numbers of visits for each follow-up year were also examined by physician type.</p></sec><sec><title>Results</title><p>The results showed that many women (>64%) in each province received care from both primary care and oncology providers during the follow-up period. The mean number of breast cancer–specific visits to primary care and visits to oncology declined with each follow-up year. Interprovincial variations were observed, with greater surgeon follow-up in Nova Scotia and greater primary care follow-up in British Columbia. Provincial differences could reflect variations in policies and recommendations, relevant initiatives, and resources or infrastructure to support <sc>pcp</sc>-led follow-up care.</p></sec><sec><title>Conclusions</title><p>Optimizing the role of <sc>pcp</sc>s in breast cancer follow-up care might require strategies to change attitudes about <sc>pcp</sc>-led follow-up and to better support <sc>pcp</sc>s in providing survivorship care.</p></sec></div></front></TEI><pmc article-type="research-article"><pmc-comment>The publisher of this article does not allow downloading of the full text in XML form.</pmc-comment>
<front><journal-meta><journal-id journal-id-type="nlm-ta">Curr Oncol</journal-id><journal-id journal-id-type="iso-abbrev">Curr Oncol</journal-id><journal-id journal-id-type="publisher-id">CO</journal-id><journal-title-group><journal-title>Current Oncology</journal-title></journal-title-group><issn pub-type="ppub">1198-0052</issn><issn pub-type="epub">1718-7729</issn><publisher><publisher-name>Multimed Inc.</publisher-name><publisher-loc>66 Martin St. Milton, ON, Canada L9T 2R2</publisher-loc></publisher></journal-meta><article-meta><article-id pub-id-type="pmid">28490921</article-id><article-id pub-id-type="pmc">5407870</article-id><article-id pub-id-type="doi">10.3747/co.24.3454</article-id><article-id pub-id-type="publisher-id">conc-24-81</article-id><article-categories><subj-group subj-group-type="heading"><subject>Original Article</subject><subj-group subj-group-type="heading"><subject>Cancer Rehabilitation and Survivorship</subject><subj-group subj-group-type="heading"><subject>Primary Care Article Series</subject></subj-group></subj-group></subj-group></article-categories><title-group><article-title>Use of physician services during the survivorship phase: a multi-province study of women diagnosed with breast cancer</article-title></title-group><contrib-group><contrib contrib-type="author"><name><surname>Kendell</surname><given-names>C.</given-names></name><degrees>MSc</degrees><xref ref-type="aff" rid="af1-conc-24-81"><sup>*</sup></xref></contrib><contrib contrib-type="author"><name><surname>Decker</surname><given-names>K.M.</given-names></name><degrees>PhD</degrees><xref ref-type="aff" rid="af2-conc-24-81"><sup>†</sup></xref><xref ref-type="aff" rid="af3-conc-24-81"><sup>‡</sup></xref></contrib><contrib contrib-type="author"><name><surname>Groome</surname><given-names>P.A.</given-names></name><degrees>PhD</degrees><xref ref-type="aff" rid="af4-conc-24-81"><sup>§</sup></xref><xref rid="c1-conc-24-81" ref-type="corresp"></xref></contrib><contrib contrib-type="author"><name><surname>McBride</surname><given-names>M.L.</given-names></name><degrees>MSc</degrees><xref ref-type="aff" rid="af5-conc-24-81"><sup>‖</sup></xref></contrib><contrib contrib-type="author"><name><surname>Jiang</surname><given-names>L.</given-names></name><degrees>MSc</degrees><xref ref-type="aff" rid="af4-conc-24-81"><sup>§</sup></xref></contrib><contrib contrib-type="author"><name><surname>Krzyzanowska</surname><given-names>M.K.</given-names></name><degrees>MD MPH</degrees><xref ref-type="aff" rid="af6-conc-24-81"><sup>#</sup></xref><xref ref-type="aff" rid="af7-conc-24-81"><sup>**</sup></xref></contrib><contrib contrib-type="author"><name><surname>Porter</surname><given-names>G.</given-names></name><degrees>MD MSc</degrees><xref ref-type="aff" rid="af1-conc-24-81"><sup>*</sup></xref><xref ref-type="aff" rid="af8-conc-24-81"><sup>††</sup></xref></contrib><contrib contrib-type="author"><name><surname>Turner</surname><given-names>D.</given-names></name><degrees>PhD</degrees><xref ref-type="aff" rid="af3-conc-24-81"><sup>‡</sup></xref><xref ref-type="aff" rid="af9-conc-24-81"><sup>‡‡</sup></xref></contrib><contrib contrib-type="author"><name><surname>Urquhart</surname><given-names>R.</given-names></name><degrees>PhD</degrees><xref ref-type="aff" rid="af1-conc-24-81"><sup>*</sup></xref><xref ref-type="aff" rid="af8-conc-24-81"><sup>††</sup></xref></contrib><contrib contrib-type="author"><name><surname>Winget</surname><given-names>M.</given-names></name><degrees>PhD</degrees><xref ref-type="aff" rid="af10-conc-24-81"><sup>§§</sup></xref></contrib><contrib contrib-type="author"><name><surname>Grunfeld</surname><given-names>E.</given-names></name><degrees>MD Phil</degrees><xref ref-type="aff" rid="af11-conc-24-81"><sup>‖‖</sup></xref></contrib><contrib contrib-type="author"><collab>For the Canadian Team to Improve Community-Based Cancer Care Along the Continuum</collab></contrib><aff id="af1-conc-24-81"><label>*</label>Cancer Outcomes Research Program, Dalhousie University and Nova Scotia Health Authority, Halifax, NS;</aff><aff id="af2-conc-24-81"><label>†</label>Department of Community Health Sciences, University of Manitoba, Winnipeg, MB;</aff><aff id="af3-conc-24-81"><label>‡</label>Epidemiology and Cancer Registry, Cancer-Care Manitoba, Winnipeg, MB;</aff><aff id="af4-conc-24-81"><label>§</label>Division of Cancer Care and Epidemiology, Cancer Research Institute, Queen’s University, Kingston, ON;</aff><aff id="af5-conc-24-81"><label>‖</label>Cancer Control Research, BC Cancer Agency, Vancouver, BC;</aff><aff id="af6-conc-24-81"><label>#</label>University Health Network, Toronto, ON;</aff><aff id="af7-conc-24-81"><label>**</label>Cancer Care Ontario, Toronto, ON;</aff><aff id="af8-conc-24-81"><label>††</label>Department of Surgery, Dalhousie University, Halifax, NS;</aff><aff id="af9-conc-24-81"><label>‡‡</label>University of Manitoba, Winnipeg, MB;</aff><aff id="af10-conc-24-81"><label>§§</label>Stanford University School of Medicine, Stanford, CA, U.S.A.;</aff><aff id="af11-conc-24-81"><label>‖‖</label>Department of Family and Community Medicine, University of Toronto, Toronto, ON.</aff></contrib-group><author-notes><corresp id="c1-conc-24-81">Correspondence to: Patti Groome, Division of Cancer Care and Epidemiology, Cancer Research Institute, Queen’s University, Kingston, Ontario K7L 3N6. E-mail: <email>groomep@queensu.ca</email></corresp></author-notes><pub-date pub-type="ppub"><month>4</month><year>2017</year></pub-date><pub-date pub-type="epub"><day>27</day><month>4</month><year>2017</year></pub-date><volume>24</volume><issue>2</issue><fpage>81</fpage><lpage>89</lpage><permissions><copyright-statement>2017 Multimed Inc.</copyright-statement><copyright-year>2017</copyright-year></permissions><abstract><sec><title>Introduction</title><p>Oncologists have traditionally been responsible for providing routine follow-up care for cancer survivors; in recent years, however, primary care providers (<sc>pcp</sc>s) are taking a greater role in care during the follow-up period. In the present study, we used a longitudinal multi-province retrospective cohort study to examine how primary care and specialist care intersect in the delivery of breast cancer follow-up care.</p></sec><sec><title>Methods</title><p>Various databases (registry, clinical, and administrative) were linked in each of four provinces: British Columbia, Manitoba, Ontario, and Nova Scotia. Population-based cohorts of breast cancer survivors were identified in each province. Physician visits were identified using billings or claims data and were classified as visits to primary care (total, breast cancer–specific, and other), oncology (medical oncology, radiation oncology, and surgery), and other specialties. The mean numbers of visits by physician type and specialty, or by combinations thereof, were examined. The mean numbers of visits for each follow-up year were also examined by physician type.</p></sec><sec><title>Results</title><p>The results showed that many women (>64%) in each province received care from both primary care and oncology providers during the follow-up period. The mean number of breast cancer–specific visits to primary care and visits to oncology declined with each follow-up year. Interprovincial variations were observed, with greater surgeon follow-up in Nova Scotia and greater primary care follow-up in British Columbia. Provincial differences could reflect variations in policies and recommendations, relevant initiatives, and resources or infrastructure to support <sc>pcp</sc>-led follow-up care.</p></sec><sec><title>Conclusions</title><p>Optimizing the role of <sc>pcp</sc>s in breast cancer follow-up care might require strategies to change attitudes about <sc>pcp</sc>-led follow-up and to better support <sc>pcp</sc>s in providing survivorship care.</p></sec></abstract><kwd-group><kwd>Breast cancer</kwd><kwd>survivors</kwd><kwd>follow-up care</kwd><kwd>primary care</kwd></kwd-group></article-meta></front></pmc></record>Pour manipuler ce document sous Unix (Dilib)
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