Centro Javeriano de Oncología, Hospital Universitario San Ignacio, Bogotá, Colombia
Maylin Peñaloza, Oswaldo Sánchez, María A. García, Raúl Murillo
Cancer survival has significantly increased during the past few decades, making survivorship care a key element of cancer control and posing several challenges for long-term care in low- and middle-income countries (LMIC). Most survivorship care guidelines emphasize the potential role of primary care physicians and the need for comprehensive care, with a preference for patient-centered over disease-centered approaches. However, guidelines developed in high-income countries are not always suitable for LMIC, where a shortage of oncology workforce, deficient training in primary care, and low access to comprehensive centers frequently induce undertreatment and a lack of follow-up. Despite universal health insurance coverage, Colombia has fragmented cancer care with deficient survivorship care, given its focus on relapse surveillance without integration of supportive care and comorbidity management, in addition to unequal access for low-income populations and distant regions. Using the breast cancer framework, we describe the development of a guideline for survivorship care on the basis of a risk approach and the proper integration of oncology specialists and family physicians. We used a three-phase process to develop recommendations for disease control (disease-centered review), interventions aimed at improving patients' quality of life (patient-centered review), and care delivery (delivery model review). We deem our proposal suitable for middle-income countries, which represents an input for more standardized survivorship care in these settings.
Journal of Clinical Oncology
First Author: Larissa Nekhlyudov
Publish Date: Oct 2, 2024
JCO Global Oncology
First Author: Erika Damasco-Avila
Publish Date: Jun 29, 2023
Journal of Clinical Oncology
First Author: Lauren P. Wallner
Publish Date: Oct 12, 2017
Journal of Clinical Oncology
First Author: Craig C. Earle
Publish Date: Sep 24, 2012