A professional view of how oncology HCPs approach recurrence surveillance, persistent treatment effects, long-term follow-up, care coordination, and the transition from active treatment to survivorship-focused care
Audience: Oncology HCPs
Countries: 6
Completion Rate: 73.5%
SGID: 9007321
-Hero findings
– Quick Read — Key Findings
Survivorship care begins with a basic question: which patients need more intensive surveillance, and why?
Stage III-IV disease is the most selected survivor profile warranting intensified follow-up at 46.1%, with intensive multimodal therapy (28.1%) and persistent toxicity (21.3%) behind. Asked which finding most influences surveillance intensity, recurrence risk again leads at 46.1%, with cancer stage and biology at 27.0% and persistent toxicity and new symptoms selected less often.
Post-treatment follow-up is rarely a choice between guidelines and judgment. In practice, the two often operate together.
Guideline-based imaging is the most selected primary surveillance strategy at 42.0%, with individualized risk-based surveillance close behind at 38.6%, biomarker-guided at 11.4% and symptom-driven at 8.0%. The narrow gap between guideline-led and risk-based approaches suggests clinicians value standardized schedules while still adjusting intensity to disease biology, prior therapy, patient risk and the clinical course.
The survey does not point to one overwhelming clinical obstacle. Instead, several different sources of uncertainty compete for attention.
Uncertain recurrence risk leads the factors limiting effective survivorship management at 28.4%, closely followed by limited follow-up capacity (25.0%), comorbidity complexity (23.9%) and persistent treatment toxicities (22.7%). For HCPs, that means follow-up can be difficult even when the schedule is clear: the challenge may come from uncertainty about recurrence, lack of appointment capacity, growing comorbidity burden or unresolved treatment effects.
Survivorship care can begin before anticancer treatment is completely finished, especially when toxicity changes what can safely or realistically continue.
Dose reduction or modification is the most selected response to persistent treatment toxicity at 44.3%, with symptom-directed pharmacotherapy (33.0%), specialist referral (18.2%) and supportive rehabilitation (4.5%) behind. This is not a universal recommendation to reduce therapy; it reflects how respondents say they commonly respond when toxicity becomes clinically important, and the right decision depends on treatment intent, cancer control, the specific toxicity and available alternatives.
Late effects are not simply symptoms to record. Some can change the specialists involved, the tests required, and the balance between recurrence surveillance and chronic disease management.
Treatment-related cardiotoxicity is the complication most often changing survivorship strategy at 46.6%, ahead of cognitive impairment (22.7%), chemotherapy-induced neuropathy (20.5%) and secondary malignancy risk (10.2%). ASCO guidance on cancer-treatment-related cardiac dysfunction emphasizes risk assessment, symptom review, appropriate cardiac evaluation and cardiology referral when indicated, reinforcing why survivorship pathways must accommodate treatment-specific late effects, not only recurrence
The shift from oncology-led surveillance toward longer-term survivorship care is not only a clinical decision. It is also a handoff.
Stable surveillance findings are the most selected factor supporting transition to long-term follow-up at 39.8%, with low recurrence risk at 28.4%. Yet asked about coordinated care, 54.0% named fragmented oncology-primary care coordination as the biggest barrier. NCI and ASCO survivorship resources emphasize treatment summaries, follow-up plans and communication across the care team, suggesting these coordination mechanisms may matter as much as the surveillance technology itself.
Biomarker-based recurrence detection leads future priorities at 32.2%, followed by AI-based recurrence-risk prediction (28.7%), digital toxicity monitoring (20.7%) and personalized survivorship pathways (18.4%).
The survey points to a pathway in which recurrence surveillance remains central but is only one part of the work: persistent toxicity, cardiotoxicity, comorbidities, limited follow-up capacity and the oncology-to-primary-care transition all shape what happens after treatment.
The strongest system-level signal is fragmentation: stable imaging or lower recurrence risk may make long-term follow-up appropriate, but the handoff still needs clarity on who monitors recurrence, who manages late effects, who owns preventive care, and how new symptoms move back into specialist assessment.
Future tools such as biomarkers and AI may make risk assessment more precise, but their value will depend on whether the surrounding care pathway can translate a risk signal into timely, coordinated action.
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Direct answers to common professional questions about post-treatment surveillance, late effects, long-term follow-up, and coordinated survivorship care.
Direct answers to the questions healthcare professionals are most likely to ask about these findings.
