[The growing snowball in health services: long-term cancer survivors]

One of the consequences of diagnostic and therapeutic progress in cancer is the increased survival observed in the last few decades in Spain and elsewhere in Europe. New cancer cases are increasing steadily due to population aging, among other factors. Consequently, the number of long-term survivors can be expected to increase in the years to come. This increase will tax healthcare systems, which are already showing the limitations of the present model of follow-up. New scenarios should be assessed and proposed from both the management and clinical perspectives. Although there is insufficient scientific evidence to indicate the most effective way to organize the follow-up of these patients, several approaches are being proposed in other countries to improve the fit between health services provision and the specific needs of these patients. In Spain, these experiences are scarce. However, given the situation, which could be described as a snowball effect, the current model should be reviewed and new approaches discussed in order to provide a more effective response to this situation. This article aims to identify the priorities for cancer survivors from the healthcare point of view, to review organizational approaches in other countries, and to propose a framework, based on the integration of the different levels of health care, including primary care - the Cinderella of this situation - in order to assess various healthcare options for these patients in the Spanish healthcare context.