Barriers to breast cancer survivorship care in primary health care: An integrative literature review

Due to earlier recognition and advances in cancer treatment, increasing numbers of women are surviving breast cancer. In Canada, these women are transitioned back to their Primary Care Providers (PCPs), including Nurse Practitioners (NPs) and physicians, soon after their cancer treatment is complete. However, the research suggests that there are numerous barriers that hinder PCPs from delivering evidence-based care to breast cancer survivors. The purpose of this project was to answer the following research question: what are the barriers that PCPs encounter in providing breast cancer survivorship care in the primary health care setting to women who have completed active cancer treatment in Canada? To answer this question a comprehensive review of the literature was conducted. The findings of this integrative review demonstrated provider-related barriers and system-related barriers linked to knowledge deficits, attitudes, workload demands, and perceived suboptimal oncologist support. Key strategies and recommendations to overcome these barriers were examined and discussed in order to improve the care of breast cancer survivors in the primary health care setting.