Provider Follow-Up and Adherence to Imaging Surveillance Recommendations for Lung Cancer Survivors in a Nationwide Health Care System.
OpenAlex 토픽 ·
Lung Cancer Diagnosis and Treatment
Cancer survivorship and care
Lung Cancer Research Studies
[PURPOSE] With the growing number of cancer survivors and projected shortages of oncology providers, understanding who delivers survivorship care has important implications for care quality.
- 95% CI 1.31 to 1.53
- 연구 설계 cohort study
APA
J Y Wu, Nicole Lin, et al. (2026). Provider Follow-Up and Adherence to Imaging Surveillance Recommendations for Lung Cancer Survivors in a Nationwide Health Care System.. JCO oncology practice, OP2501200. https://doi.org/10.1200/OP-25-01200
MLA
J Y Wu, et al.. "Provider Follow-Up and Adherence to Imaging Surveillance Recommendations for Lung Cancer Survivors in a Nationwide Health Care System.." JCO oncology practice, 2026, pp. OP2501200.
PMID
42030509
Abstract
[PURPOSE] With the growing number of cancer survivors and projected shortages of oncology providers, understanding who delivers survivorship care has important implications for care quality. We examined follow-up provider patterns among lung cancer survivors in the Veterans Health Administration (VHA) system and assessed variation in receipt of guideline-concordant computed tomography (CT) imaging.
[METHODS] We conducted a retrospective cohort study of 20,532 Veterans with stage I to III non-small cell lung cancer who received definitive treatment between 2008 and 2016. The primary exposure was the lung cancer survivor's follow-up provider specialty, defined as the specialty with whom the patient received the most post-treatment follow-up visits. We evaluated associations between treatment type and follow-up provider specialty and compared receipt of guideline-concordant surveillance imaging, defined as chest CT performed 120-270 days after treatment, across specialties using multivariable logistic regression, adjusted for demographic, clinical, and facility characteristics.
[RESULTS] Follow-up care frequently shifted to specialties different from those delivering definitive treatment. Among patients treated with surgery alone, most patients, 61% transitioned to primary care for follow-up, while 27% remained with surgery. Patients followed by medical oncology had the highest rates of guideline-concordant chest CT (72.8% 66.2% in primary care, adjusted odds ratio, 1.42 [95% CI, 1.31 to 1.53]; < .001). Chest radiography was used in 26% of cases, most often in primary care and surgical clinics.
[CONCLUSION] Survivorship follow-up for lung cancer in the VHA often shifted to primary care, where adherence to guideline-concordant chest CT was lower than in medical oncology. These shifts in care may have further implications for post-treatment outcomes and survivorship care, highlighting the opportunity to support nononcology providers in delivering guideline-concordant care as survivorship workforce demands grow.
[METHODS] We conducted a retrospective cohort study of 20,532 Veterans with stage I to III non-small cell lung cancer who received definitive treatment between 2008 and 2016. The primary exposure was the lung cancer survivor's follow-up provider specialty, defined as the specialty with whom the patient received the most post-treatment follow-up visits. We evaluated associations between treatment type and follow-up provider specialty and compared receipt of guideline-concordant surveillance imaging, defined as chest CT performed 120-270 days after treatment, across specialties using multivariable logistic regression, adjusted for demographic, clinical, and facility characteristics.
[RESULTS] Follow-up care frequently shifted to specialties different from those delivering definitive treatment. Among patients treated with surgery alone, most patients, 61% transitioned to primary care for follow-up, while 27% remained with surgery. Patients followed by medical oncology had the highest rates of guideline-concordant chest CT (72.8% 66.2% in primary care, adjusted odds ratio, 1.42 [95% CI, 1.31 to 1.53]; < .001). Chest radiography was used in 26% of cases, most often in primary care and surgical clinics.
[CONCLUSION] Survivorship follow-up for lung cancer in the VHA often shifted to primary care, where adherence to guideline-concordant chest CT was lower than in medical oncology. These shifts in care may have further implications for post-treatment outcomes and survivorship care, highlighting the opportunity to support nononcology providers in delivering guideline-concordant care as survivorship workforce demands grow.