What stands between childhood cancer survivors and survivorship care?

Gaps in health system infrastructure can contribute to fewer childhood cancer survivors receiving guideline-concordant survivorship care, according to a review published Dec. 26 in Cancer Control. 

Researchers from Jacksonville, Fla.-based University of Florida and Los Angeles-based University of Southern California led the review which analyzed 49 studies found through PubMed, CINAHL and PsycINFO to identify barriers to and facilitators of survivorship care for childhood cancer survivors.

The most influential barriers to survivorship care were:

• Lack of knowledge 
• Inaccurate belief that survivorship care is not needed or redundant
• Active avoidance or lack of trust and confidence related to a high level of healthcare trauma and anxiety 
• Lack of local providers with experience in survivorship care
• Gaps in health system infrastructure
• Financial toxicity and hardship, and housing insecurity
• Lack of insurance coverage
• Navigating health system scheduling
  

The most influential facilitators of survivorship care were:

• Providing patients with a survivorship care plan or treatment summary
• Supporting patient autonomy 
• Prioritizing clinician-patient relationships
• Enhanced care coordination and communication
  

“We found strong empirical evidence of barriers to and facilitators of survivorship care, including potentially modifiable factors surrounding knowledge, prioritization and infrastructure,” the study authors said. “Prospective, multilevel approaches are needed to improve the receipt of guideline-concordant survivorship care among childhood cancer survivors.”

Read the full review here. 

Editor’s note: This article was updated Jan. 28, 2026 at 2:32pm CT.