Subsequent Oncology Visits Among Cancer Survivors Transitioned to Primary Care: A Retrospective Cohort Study

Purpose: There is increasing focus on transitioning cancer survivors from oncology to primary care, yet little is known about why some patients return to oncology following transition. We aimed to describe the reasons for and outcomes of subsequent oncology visits among cancer survivors transitioned to primary care. Methods: We conducted a retrospective cohort study of patients transitioned to primary care at the Juravinski Cancer Centre. We analyzed all patients transitioned to primary care from 2013–2020. A chart review was completed for transitioned patients with subsequent oncology visits to determine the reasons for return and subsequent investigations/treatments. Results: Among 2,604 transitioned cancer survivors, 440 (16.9%) had a subsequent oncology visit. One-third were not true rereferrals but rather visits for genetic counselling, clinical trials, or palliative care follow-up (32.7%). Apart from these, the most common reasons for visit were investigation of symptoms (32.7%) or tests (23.2%). Recurrence or new disease was detected in 28.2% of those with a subsequent visit, representing 4.8% of all transitioned patients. Most of these patients went on to receive treatment. Conclusions: Only a small proportion of transitioned patients were referred back to oncology, and recurrence was detected in a small fraction of the overall cohort, supporting the safety of primary-care led survivorship. Patients were seen for many reasons and were readily able to reconnect with oncology regardless of underlying pathology. Implications for Cancer Survivors: Transitioning cancer survivors to primary care appears safe, with low recurrence rates and the ability to readily re-access oncology care when needed.