Despite being critical to models of coordinated care, the relationship and communication between primary care providers (PCPs) and cancer specialists throughout the cancer continuum is poorly understood. Using pre-defined search terms, we conducted a systematic review of the literature in three databases to examine the relationship and communication between PCPs and cancer specialists. Among 301 articles identified, 35 met all inclusion criteria and were reviewed in-depth. We integrated findings from qualitative, quantitative, and disaggregated mixed methods studies using meta-synthesis. Six themes were identified and incorporated into a preliminary conceptual model of the PCP-cancer specialist relationship: (1) poor and delayed communication between PCPs and cancer specialists, (2) cancer specialists’ endorsement of a specialist-based model of care, (3) PCPs’ belief that they play an important role in the cancer continuum, (4) PCPs’ willingness to participate in the cancer continuum, (5) cancer specialists’ and PCPs’ uncertainty regarding the PCP’s oncology knowledge/experience, and (6) discrepancies between PCPs and cancer specialists regarding roles. These data indicate a pervasive need for improved communication, delineation and coordination of responsibilities between PCPs and cancer specialists. Future interventions aimed at these deficiencies may improve patient and physician satisfaction and cancer care coordination.

Purpose The Adolescent and Young Adult (AYA) community is an underserved population due to unique quality of life and late-effect issues, particularly future fertility. This study sought to establish rates of documentation of discussion of risk of infertility, fertility preservation (FP) options, and referrals to fertility specialists in AYA patients’ medical records at four cancer centers. Methods All centers reviewed randomized medical records within the four most common disease sites among AYAs (breast, leukemia/lymphoma, sarcoma, and testicular). Eligible patient records included: 1) diagnosed in 2011 with no prior gonadotoxic therapy; 2) ages 18–45; 3) no multiple primary cancers; and 4) not second opinions. Quality Oncology Practice Initiative (QOPI) methods were used to evaluate documentation of: a) discussion of risk of infertility; b) discussion of FP options; and c) referral to a fertility specialist. Results A total of 231 records were analyzed. Overall, 61 (26%) of records documented item a; 56 (24%) documented item b; and 31 (13%) documented item c. Female (p = 0.030; p = 0.004) and breast cancer (p = 0.021; p < 0.001) records were less likely to contain evidence of a and b. Conclusion The overall rate of documentation is low and results show disparities among specific groups. While greater numbers of discussions may be occurring, there is need to create interventions to improve documentation. Rates may improve with increased provider education and other intervention efforts.