Primary care provider-led cancer survivorship care in the first 5 years following initial cancer treatment: a scoping review of the barriers and solutions to implementation

PURPOSE

To synthesize the barriers to primary care provider (PCP)-led cancer survivorship care (≤ 5 years after initial cancer treatment) experienced by healthcare systems around the world, and to explore potential solutions that would succeed within a developed country.

METHODS

A scoping review of peer-reviewed articles and grey literature was conducted. Four electronic databases (Medline, Embase, Web of Science Core Collection, and Google Scholar) were searched for articles prior to April 2021.

RESULTS

Ninety-seven articles published across the globe (USA, Canada, Australia, European Union, and UK) met the review inclusion/exclusion criteria. The four most frequently discussed barriers to PCP-led survivorship care in healthcare systems were as follows: (1) insufficient communication between PCPs and cancer specialists, (2) limited PCP knowledge, (3) time restrictions for PCPs to provide comprehensive survivorship care, and (4) a lack of resources (e.g., survivorship care guidelines). Potential solutions to combat these barriers were as follows: (1) improving interdisciplinary communication, (2) bolstering PCP education, and (3) providing survivorship resources.

CONCLUSIONS

This scoping review identified and summarized key barriers and solutions to the provision of PCP-led cancer survivorship care. Importantly, the findings from this review provide insight and direction to guide optimization of cancer care practice within BC's healthcare system.

IMPLICATIONS FOR CANCER SURVIVORS

Optimizing the PCP-led survivorship care model will be a valuable contribution to the field of cancer survivorship care and will hopefully lead to more widespread use of this model, ultimately lessening the growing demand for cancer-specific care by cancer specialists.

Acanthobothrium nicoyaense n. sp. (Eucestoda: Tetraphyllidea: Onchobothriidae) in Aetobatus narinari (Euphrasen) (Chondrichthyes: Myliobatiformes: Myliobatidae) from the Gulf of Nicoya, Costa Rica

A new species of Acanthobothrium in Aetobatus narinari from the Gulf of Nicoya, Costa Rica, most closely resembles Acanthobothrium colombianum in the same host and A. urotrygoni in Urotrygon venezuelae from Cartagena, Colombia, by having relatively few proglottides per strobila, spinose cephalic peduncles, bothridial margins free at their posterior ends, and irregularly shaped rather than spherical or elongate cirrus sacs. Acanthobothrium colombianum differs from the new species by being as much as 35 mm rather than no more than 4.7 mm long and by having 31-48 rather than 13-19 proglottides, an average of 46 rather than 15 testes per proglottis, and bothridial hooks averaging 185 microns rather than 137 microns in total length. Acanthobothrium urotrygoni differs from the new species by being as much as 15 mm rather than no more than 4.7 mm long and by having V-shaped rather than H-shaped ovaries, bothridial hooks averaging 95 microns rather than 137 microns in total length, by having an average of 28 rather than 15 testes per proglottis, and by having poral ovarian arms extending anteriorly to the posterior margin of the cirrus sac and aporal arms extending to the lateral margin of the cirrus sac.