Are Primary Care Providers Prepared to Care for Breast Cancer Survivors in the Safety Net?

A woman talking to a doctor in an examination room.

Executive Summary: Most providers believe primary care providers (PCPs) have the necessary skills to provide cancer-related follow-up. The majority, however, were uncomfortable providing these services themselves.

The Issue:
The growing number of breast cancer survivors is outpacing the capacity of oncology providers, prompting the transition of patients back to primary care. However, primary care providers (PCPs) may have less experience and limited knowledge around treating survivors.

Key Findings:

  • Most providers believe PCPs have the necessary skills to provide cancer-related follow-up.
  • The majority, however, were uncomfortable providing these services themselves. Only 20 percent of PCPs reported feeling very confident about their ability to perform specific aspects of survivorship care.
  • While providers adhered to the American Society of Clinical Oncology recommendations for mammography (98%) and physical exam (87%), less than one-third followed recommendations for lab testing. Overall, only six providers, or 10 percent, adhered to all recommendations.

Conclusion:
The universal requests among the study’s PCPs for additional training on clinical guidelines and written survivorship care plans prior to transfer highlight safety-net providers current lack of knowledge and confidence in providing care for breast cancer survivors. Focused efforts around additional training are necessary to ensure PCPs are prepared to offer survivorship care.

About the Study:
Physicians and non-physician providers from two primary care networks within the Los Angeles County Department of Health Services were surveyed on survivorship care. Of the 115 providers who received the survey, 59 participated. Additional qualitative focus groups supplemented the study.