{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,21]],"date-time":"2026-08-21T12:25:36Z","timestamp":1787315136974,"version":"build-2736575974"},"reference-count":28,"publisher":"MDPI AG","issue":"3","license":[{"start":{"date-parts":[[2023,2,24]],"date-time":"2023-02-24T00:00:00Z","timestamp":1677196800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Hamilton Health Sciences Foundation"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Current Oncology"],"abstract":"<jats:p>Healthcare systems in Canada and elsewhere have identified the need to develop methods to effectively and safely transition appropriate cancer survivors to primary care. It is generally accepted that survivors with a low risk of adverse events, including recurrence and toxicity, should be more systematically identified and offered transition. There remains a lack of clarity about what constitutes an appropriate profile that would assist greater application in practice. To address this gap, we examined the clinical profiles of patients that were transitioned from a large regional cancer centre to the community. The factors examined included disease site, clinical stage, time since diagnosis\/first consult, cancer treatments, and Edmonton Symptom Assessment System (ESAS) scores. In total, 2604 patients were identified as transitioned between 2013 and 2020. These patients tended to have common cancers (e.g., breast, endometrium, colorectal) that were generally of lower stage. Half of the patients had received chemotherapy and\/or radiation treatment. Nearly one-third of survivors were transitioned within a year of first consult and a third after five years. Most patients reported minimal symptoms based on ESAS scores prior to being transitioned. This study represents one of the first to analyze the types of cancer patients that are being selected for transition to primary care.<\/jats:p>","DOI":"10.3390\/curroncol30030207","type":"journal-article","created":{"date-parts":[[2023,2,24]],"date-time":"2023-02-24T03:37:20Z","timestamp":1677209840000},"page":"2743-2750","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Optimizing Cancer Survivorship Care: Examination of Factors Associated with Transition to Primary Care"],"prefix":"10.3390","volume":"30","author":[{"given":"Som. D.","family":"Mukherjee","sequence":"first","affiliation":[{"name":"Juravinski Cancer Center, Hamilton Health Sciences, Department of Oncology, McMaster University, Hamilton, ON L8S 4L8, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9249-8229","authenticated-orcid":false,"given":"Daryl","family":"Bainbridge","sequence":"additional","affiliation":[{"name":"Juravinski Cancer Center, Hamilton Health Sciences, Department of Oncology, McMaster University, Hamilton, ON L8S 4L8, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher","family":"Hillis","sequence":"additional","affiliation":[{"name":"Juravinski Cancer Center, Hamilton Health Sciences, Department of Oncology, McMaster University, Hamilton, ON L8S 4L8, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7702-8816","authenticated-orcid":false,"given":"Jonathan","family":"Sussman","sequence":"additional","affiliation":[{"name":"Juravinski Cancer Center, Hamilton Health Sciences, Department of Oncology, McMaster University, Hamilton, ON L8S 4L8, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2023,2,24]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1996","DOI":"10.1158\/1055-9965.EPI-11-0729","article-title":"Cancer survivors: A booming population","volume":"20","author":"Parry","year":"2011","journal-title":"Cancer Epidemiol. Biomark. Prev."},{"key":"ref_2","unstructured":"Canadian Cancer Society (2023, January 31). Canadian Cancer Statistics: A 2022 Special Report on Cancer Prevalence. Available online: https:\/\/cancer.ca\/en\/research\/cancer-statistics\/canadian-cancer-statistics."},{"key":"ref_3","unstructured":"National Academies of Sciences, Engineering, and Medicine, Health and Medicine Division, Board on Health Care Services, and National Cancer Policy Forum (2018). Long-Term Survivorship Care after Cancer Treatment: Proceedings of a Workshop, National Academies Press."},{"key":"ref_4","first-page":"172","article-title":"What constitutes ideal survivorship care?","volume":"33","author":"Schofield","year":"2009","journal-title":"Cancer Forum"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"184","DOI":"10.1200\/JOP.2011.000312","article-title":"Providing care for cancer survivors in integrated health care delivery systems: Practices, challenges, and research opportunities","volume":"8","author":"Chubak","year":"2012","journal-title":"J. Oncol. Pract."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"25","DOI":"10.1093\/jncimonographs\/lgq002","article-title":"The interface between primary and oncology specialty care: Treatment through survivorship","volume":"2010","author":"Grunfeld","year":"2010","journal-title":"J. Natl. Cancer Inst. Monogr."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"81","DOI":"10.3747\/co.24.3454","article-title":"Use of Physician Services during the Survivorship Phase: A Multi-Province Study of Women Diagnosed with Breast Cancer","volume":"24","author":"Kendell","year":"2017","journal-title":"Curr. Oncol."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"442","DOI":"10.1093\/jnci\/djy232","article-title":"Personalized risk-stratified cancer follow-up care: Its potential for healthier survivors, happier clinicians, and lower costs","volume":"111","author":"Mayer","year":"2019","journal-title":"JNCI J. Natl. Cancer Inst."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"94","DOI":"10.1002\/pon.824","article-title":"Follow-up in breast cancer clinics: Reassuring for patients rather than detecting recurrence","volume":"14","author":"Beaver","year":"2005","journal-title":"Psychooncology"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"38","DOI":"10.1038\/nrclinonc.2013.212","article-title":"The role of primary care in early detection and follow-up of cancer","volume":"11","author":"Emery","year":"2014","journal-title":"Nat. Rev. Clin. Oncol."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"625","DOI":"10.1185\/030079906X96407","article-title":"Breast cancer follow-up: Could primary care be the right venue?","volume":"22","author":"Jiwa","year":"2006","journal-title":"Curr. Med. Res. Opin."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"e234","DOI":"10.3399\/bjgp09X453567","article-title":"Follow-up of cancer in primary care versus secondary care: Systematic review","volume":"9","author":"Lewis","year":"2009","journal-title":"Br. J. Gen. Pract."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"1712","DOI":"10.1002\/cncr.20560","article-title":"Under use of necessary care among cancer survivors","volume":"101","author":"Earle","year":"2004","journal-title":"Cancer"},{"key":"ref_14","first-page":"889","article-title":"Family physicians\u2019 roles in cancer care. Survey of patients on a provincial cancer registry","volume":"50","author":"Sisler","year":"2004","journal-title":"Can. Fam. Physician"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"1054","DOI":"10.1200\/JCO.2008.18.0950","article-title":"Prevention, screening, and surveillance care for breast cancer survivors compared with controls: Changes from 1998 to 2002","volume":"27","author":"Snyder","year":"2009","journal-title":"J. Clin. Oncol."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"e19","DOI":"10.1200\/JOP.2014.001403","article-title":"Models of cancer survivorship care: Overview and summary of current evidence","volume":"11","author":"Halpern","year":"2015","journal-title":"J. Oncol. Pract."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"3338","DOI":"10.1200\/JCO.2008.20.4883","article-title":"Primary care physicians\u2019 views of routine follow-up care of cancer survivors","volume":"27","author":"Grunfeld","year":"2009","journal-title":"J. Clin. Oncol."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"2164","DOI":"10.1002\/(SICI)1097-0142(20000501)88:9<2164::AID-CNCR24>3.0.CO;2-5","article-title":"Validation of the Edmonton Symptom Assessment Scale","volume":"88","author":"Chang","year":"2000","journal-title":"Cancer"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"630","DOI":"10.1016\/j.jpainsymman.2016.10.370","article-title":"The Edmonton Symptom Assessment System 25 years later: Past, present, and future developments","volume":"53","author":"Hui","year":"2017","journal-title":"J. Pain Symptom Manag."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"7672","DOI":"10.3390\/curroncol29100606","article-title":"Outcomes of early transition of low-risk thyroid cancer patients from specialist to primary care","volume":"29","author":"Nguyen","year":"2022","journal-title":"Curr. Oncol."},{"key":"ref_21","unstructured":"Cancer Care Ontario (2023, January 31). Follow-Up Model of Care for Cancer Survivors: Recommendations for the Delivery of Follow-Up Care for Cancer Survivors in Ontario. Available online: https:\/\/www.cancercareontario.ca\/sites\/ccocancercare\/files\/guidelines\/full\/FollowUpModelOfCareCancerSurvivors.pdf."},{"key":"ref_22","unstructured":"Cancer Care Ontario (2023, January 31). Guidelines & Advice: Survivorship. Available online: https:\/\/www.cancercareontario.ca\/en\/guidelines-advice\/cancer-continuum\/survivorship."},{"key":"ref_23","unstructured":"Cancer Care Ontario (2023, January 31). Pathway Maps. Available online: https:\/\/www.cancercareontario.ca\/en\/pathway-maps\/about."},{"key":"ref_24","unstructured":"NHS (2023, January 31). Innovation to Implementation: Stratified Pathways of Care for People Living with or Beyond Cancer, a \u2018How to Guide\u2019. Available online: https:\/\/www.england.nhs.uk\/wp-content\/uploads\/2016\/04\/stratified-pathways-update.pdf."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"14","DOI":"10.1038\/bjc.2012.554","article-title":"Implementing improved post-treatment care for cancer survivors in England, with reflections from Australia, Canada and the USA","volume":"108","author":"Jefford","year":"2013","journal-title":"Br. J. Cancer"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"3408","DOI":"10.3390\/curroncol28050295","article-title":"Risk-Stratified Pathways for Cancer Survivorship Care: Insights from a Deliberative Multi-Stakeholder Consultation","volume":"28","author":"Tremblay","year":"2021","journal-title":"Curr. Oncol."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/j.ejca.2018.06.006","article-title":"Patient-reported symptoms after breast cancer diagnosis and treatment: A retrospective cohort study","volume":"101","author":"Davis","year":"2018","journal-title":"Eur. J. Cancer"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"34","DOI":"10.1016\/j.ejca.2021.10.035","article-title":"The PanCareFollowUp Care Intervention: A European harmonised approach to person-centred guideline-based survivorship care after childhood, adolescent and young adult cancer","volume":"162","author":"Mulder","year":"2022","journal-title":"Eur. J. 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