Commentary: Primary care and diagnosis of cancer : The Lancet Oncology

Primary care and diagnosis of cancer : The Lancet Oncology

"..........These findings raise several questions. Do modes of cancer presentation vary systematically between different groups of patients? Are general practitioners more reluctant to refer young or non-white patients for investigation of possible cancer? Are participants in these groups less willing to accept a referral to investigate possible cancer? Lyratzopoulos and colleagues' study will raise concerns for those involved in diagnosing and treating patients with cancer. This descriptive study suggests several hypotheses concerning pathways to accessing cancer care that deserve to be tested prospectively in future research."

press release: Canada, Australia and New Zealand establish a new research partnership - CIHR

Canada, Australia and New Zealand establish a new research partnership - CIHR

Ottawa (March 20, 2012) – The Canadian Institutes of Health Research (CIHR), the Australian Primary Health Care Research Institute (APHCRI) at the Australian National University and the Health Research Council of New Zealand (HRC NZ) are partnering to fund research on innovative models of Community-based Primary Healthcare (CBPHC). As part of CIHR's Signature Initiative, funded teams will examine how to better prevent and manage chronic disease, as well as improve access to care for vulnerable populations.
Recognizing that innovative research in CBPHC is essential to better health outcomes, improved equity, reduced wait times, and an improved patient experience, the partners have agreed to support cross-jurisdictional Canada-Australia and Canada-New Zealand teams of researchers, patients, decision-makers and clinicians.
"This collaborative research between Canada, Australia, and New Zealand will allow our three countries to test different models of primary healthcare", said Dr. Beaudet, President of CIHR. "The international best practices that emerge will benefit our healthcare systems and, most importantly, contribute to better health outcomes."
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Commentary: Primary care and diagnosis of cancer : The Lancet Oncology

Commentary: Primary care and diagnosis of cancer : The Lancet Oncology

open access: A Senior Primary Care Physician Trying to Take Good Care of His Patients - — JAMA

abstract: Comparing diagnostic delay in cancer: a cross-sectional study in three European countries with primary care-led health care systems (UK, Netherlands, Sweden)

Conclusions. A large-scale study comparing cancer delays in European countries and based on primary care-held records is feasible but would require supplementary sources of data in order to maximize information on demographic variables, the cancer stage at diagnosis and treatment details. Such a large-scale study is timely and desirable since our findings suggest systematic differences in the way cancer is managed in the three countries.

BMJ Group blogs: Is it time to scrap the primary-secondary care divide?

Toward Improving the Quality of Cancer Care: Addressing the Interfaces of Primary and Oncology-Related Subspecialty Care

Note: excerpt with numerous related references/$$$ article

The interface of primary and oncology specialty care: from diagnosis through primary treatment.

The interface between primary and oncology specialty care: treatment through survivorship

The primary care physician role in cancer genetics: a qualitative study of patient experience Family Practice

Abstract

Background. Increased availability of genetic testing is changing the primary care role in cancer genetics. The perspective of primary care physicians (PCPs) regarding their role in support of genetic testing has been explored, but little is known about the expectations of patients or the PCP role once genetic test results are received.

Methods. Two sets of open-ended semi-structured interviews were completed with patients (N = 25) in a cancer genetic programme in Ontario, Canada, within 4 months of receiving genetic test results and 1 year later; written reports of test results were collected.

Results. Patients expected PCPs to play a role in referral for genetic testing; they hoped that PCPs would have sufficient knowledge to appreciate familial risk and supportive attitudes towards genetic testing. Patients had more difficulty in identifying a PCP role following receipt of genetic test results; cancer patients in particular emphasized this as a role for cancer specialists. Still, some patients anticipated an ongoing PCP role comprising risk-appropriate surveillance or reassurance, especially as specialist care diminished. These expectations were complicated by occasional confusion regarding the ongoing care appropriate to genetic test results.

Conclusions. The potential PCP role in cancer genetics is quite broad. Patients expect PCPs to play a role in risk identification and genetics referral. In addition, some patients anticipated an ongoing role for their PCPs after receiving genetic test results. Sustained efforts will be needed to support PCPs in this expansive role if best use is to be made of investments in cancer genetic services.