Cancer Care
The American Academy of Family Physicians (AAFP) supports the 2013 report of the National Academy of Medicine (formerly known as the Institute of Medicine), “Delivering High-Quality Cancer Care: Charting a New Course for a System in Crisis,” and its recognition of the need for an integrated healthcare team to address the needs of cancer patients. Family physicians should play a role at all stages of cancer care: cancer screening and diagnosis, referral for specialty care, co-management with specialty care, survivorship management, palliative care and hospice care.
The following elements of quality care should be accessible for each individual with cancer:
Cancer Diagnosis: Patients should have access to healthcare to ensure evidence-based screening and cancer detection.
Referral for Specialty Care: Patients should have affordable and accessible options for cancer care. Accurate staging and prognosis should be completed and communicated in language that patients can understand. The cancer-care team should present staging and management options with a clear explanation of the benefits and expected side effects. There should be written communication back to the referring family physician.
Co-management with Specialty Care: The cancer-care team should include family physicians and other specialized healthcare clinicians. Patients should be provided with understandable information on their cancer prognosis, treatment benefits and harms, palliative care, psychosocial support, and the estimated cost of their cancer care. There should be timely and thorough communication between all members of the care team. Cancer care teams should work collaboratively and communicate with family physicians during care transitions, (e.g., starting/ending treatment, hospital to home, etc.) to ensure continuity and improve patient safety and outcomes. Co-management should recognize the complexity and cost of care and should work toward adherence to cost-effective, evidence-based treatment algorithms in line with patient needs, values, and preferences.
Survivorship Management: Patients should have access to appropriate surveillance and screening tests specific to the cancer they have had, and the potential long-term side effects of treatments they have received. Family physicians should be educated about the protocols for survivorship management, including the treatment of any side effects the patient may experience resulting from their cancer treatment. The cancer-care team should coordinate the creation of a transition-of -care document to clarify who will be responsible for conducting the ongoing cancer surveillance and recommended testing and follow-up.
End-of-Life Care: Patients should have access to end-of-life care consistent with their needs, values, and preferences. Patients should be engaged in the development of a care plan that considers palliative care needs and psychosocial support throughout the cancer care continuum. Patients should be given accurate information about their prognosis, and this information should be included in documents that are shared with other members of the cancer-care team.
Cancer Disparities: The AAFP acknowledges persistent disparities in cancer outcomes and that these inequities in cancer outcomes reflect the cumulative effects of social determinants of health, discrimination, environmental exposures, allostatic load, and unequal access to prevention, screening, and treatment. Family medicine is uniquely positioned to advance equitable cancer prevention and care across the continuum while advocating for policies that address the upstream conditions driving these disparities. (May 2016 BOD) (April 2026 BOD)