Globally, the incidence of cancer, and the prevalence of cancer survivors, is increasing. Survivors experience a broad range of consequences as a result of cancer and cancer treatments. Many of these symptom issues and unmet needs are experienced by survivors in all countries. All countries are struggling with how to deliver optimal survivorship care. There is currently significant variation in care delivery, even between countries with similar income economies. There are major opportunities to share experience and resources and to work collaboratively to tackle the challenges of cancer survivorship.
The International Psycho-Oncology Society (IPOS) recently undertook a global review of national cancer control plans, finding that few include survivorship-focussed objectives. An international survey of health professionals conducted by IPOS found that having survivorship-focussed policy and guidelines were enablers of more comprehensive survivorship care at the national level. There are numerous survivorship guidelines, internationally, including a small number of resource-stratified guidelines.
Many countries report limited awareness of survivorship and a lack of education and training opportunities. Several free online resources are available which could be shared and expanded to support training requirements.
Likewise, information and support programs for survivors and carers can be shared and potentially implemented in diverse settings. Non-government organisations have an important role in supporting improved survivorship care; again, there are opportunities to share successful programs.
Several models of care (including nurse-led, shared care with general practitioners (GPs) and GP-led models) have been studied in randomised controlled trials. Generally, these models appear at least as effective as traditional oncologist-led follow up, though offer a range of advantages. While recognising that these studies have been conducted in a relatively small number of countries, often with universal healthcare, findings suggest that these models might be broadly applicable.
More work needs to be done to collect and report a range of outcomes for cancer survivors. This work could be progressed internationally.
Acknowledging that solutions will need to be tailored to local circumstances, there are major opportunities for countries to network, to share resources and experience, and to work collaboratively to improve care and outcomes for cancer survivors.