J Korean Med Sci.  2013 May;28(5):651-657. 10.3346/jkms.2013.28.5.651.

Management of Cancer Survivors in Clinical and Public Health Perspectives: Current Status and Future Challenges in Korea

• Shin DW
• Cho B
• Kim SY
• Jung JH
• Park JH

• KMID: 1777550
• DOI: http://doi.org/10.3346/jkms.2013.28.5.651

Abstract

The number of cancer survivors is increasing dramatically. Many cancer survivors face lifetime risks associated with their cancer therapy, with a significant proportion at risk for serious morbidity and premature mortality. Concerns regarding the long-term physical, psychosocial, and economic effects of cancer treatment on cancer survivors and their families are increasingly being recognized and addressed by public and private sector. This article summarizes economic burden of cancer survivors, main post-treatment health problems including secondary primary cancer and comorbidities, health behaviors such as smoking, exercise and physical activity, nutrition, and psychosocial problems. Faced with various health and psychosocial problems specific to this population, several healthcare and policy models are being suggested to address these issues, including 'shared care model' and 'integrative supportive care service delivery system for cancer survivors'. More effort is needed to make the cancer survivorship agenda a reality, attended by a wide variety of stakeholders including researchers, patients, providers, and policy makers.

Keyword

Cancer; Survivors; Second Primary Neoplasm; Korea

MeSH Terms

Delivery of Health Care
Health Behavior
Health Services Needs and Demand
Humans
Mental Health
Neoplasms/economics/pathology/*therapy
Neoplasms, Second Primary/epidemiology/mortality/pathology
*Public Health
Republic of Korea

Figure

• 

  Fig. 1 Trend of medical expenses of cancer survivors compared with general population. Medical expenses covered by the National Health Insurance (not including out-of-pocket payments).

• 

  Fig. 2 Model for shared care of cancer survivors. Solid line connotes primary responsibility; Dashed line connotes secondary responsibility. CA, cancer; DX, diagnosis; Off RX, completion of cancer therapy; PCP, primary care physician; ISCC, integrated supportive cancer center. a, cancer diagnosis and planned therapeutic approach; b, cancer summary (care plan), cancer diagnosis, cancer therapy, surveillance recommendations, contact information; c, periodic update with changes in surveillance recommendations and new information regarding potential late effects; d, periodic update of survivo's health for primary care physician's record.

• 

  Fig. 3 Lifetime risk-based cancer survivorship healthcare delivery system.

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