The University of Iowa Division of Pediatric Hematology/Oncology has had more than 20 years of experience delivering care to children with cancer in which academic pediatric/oncologists share management with primary-care physicians. To evaluate the quality of care under this delivery system, we compared survey data from 242 shared cancer management patients with a statistically matched control sample of children from other pediatric oncology centers where cancer management is done by sub-specialists only. Survival outcomes, Goodwin's Pediatric Oncology Quality of Life Scale for children with cancer, currently reported health problems, and the parent's direct ratings of their child's health are not significantly different by shared or specialist management. We also compared the children's developmental perspectives, family evaluation of care and transportation costs. From this analysis, we conclude that shared management is equal to specialist management in quality but is preferable from the family's perspective when medical and travel costs are lower. We suggest shared management also supports the transition of children with cancer back to their primary-care physician for management of the child's other medical needs and post-cancer care.