Due to advances in early detection and treatment, the number of cancer survivors is increasing dramatically. However, along with this long-term survival, cancer survivors face substantial risks for morbidity, reduced quality of life and premature mortality. As a result, there is a growing international effort to formalize and assure a future for cancer survivorship through improvements in clinical care, research and education/training. The important guidance of seminal reports about survivorship will serve as a background for this presentation. Key concepts underpinning the clinical and research initiatives endeavoring to improve the quality of care for cancer survivors will be reviewed. Specifically, details about the evolving models of survivorship care will be discussed along with the strengths and weaknesses of each. Current knowledge about the challenges and opportunities of risk-based care and the coordination of care between oncology and primary care providers using treatment summaries/ care plans as a communication tool will be presented. Unique survivorship population concerns, such as the elderly, will be highlighted. Practical suggestions for developing survivorship services with limited resources will be offered with opportunity for comment and discussion. Importantly, the details of these survivorship system changes will be presented in the context of how research is needed to inform improvements in clinical care.