Care of long term adult cancer survivors in primary care


Year:

Session type:

Peter Rose
Department of Primary Health Care, University of Oxford, UK

Abstract

Background
There are over 1 million cancer survivors in the UK and many are cared for exclusively in primary care. There is limited knowledge from research of their specific health care needs. The Cancer Reform Strategy aims to develop a national programme to address these needs.

This talk will provide an overview of the primary care needs of adult cancer survivors, supported by early data from an ongoing research study. It will also discuss service issues in primary care relating to the Cancer Reform Strategy.

Research and method
1) A systematic review of 10 published studies that specifically considered primary care aspects of surviving adult cancer and discharge of cancer patients from secondary care at least 3 years after diagnosis. 

2) A dataset analysis of 18,777 breast, 5,825 colon and 4,901 prostate cancer cases and their 4 controls, all at least 5 years from diagnosis using the General Practice Research Database (GPRD).

Results
1) Cancer screening is well managed in survivors. Preventative and chronic disease care are worse in long-term colorectal cancer survivors compared with breast cancer survivors. 

2) Compared with controls, cancer survivors had an increased consultation rate in the year after completion of treatment and in the year following discharge from hospital follow up. There was also an increase in consultations for pain and depression in the year following discharge from hospital follow up

Primary care issues
Implementation of the survivor care plan will assist primary care in providing more appropriate treatment for adult cancer survivors. However, risk stratification of needs, balancing cancer needs with those of co-morbidities and implementation of recall systems in primary care will be necessary to deliver optimum care.

Background
There are over 1 million cancer survivors in the UK and many are cared for exclusively in primary care. There is limited knowledge from research of their specific health care needs. The Cancer Reform Strategy aims to develop a national programme to address these needs.

This talk will provide an overview of the primary care needs of adult cancer survivors, supported by early data from an ongoing research study. It will also discuss service issues in primary care relating to the Cancer Reform Strategy.

Research and method
1) A systematic review of 10 published studies that specifically considered primary care aspects of surviving adult cancer and discharge of cancer patients from secondary care at least 3 years after diagnosis. 

2) A dataset analysis of 18,777 breast, 5,825 colon and 4,901 prostate cancer cases and their 4 controls, all at least 5 years from diagnosis using the General Practice Research Database (GPRD).

Results
1) Cancer screening is well managed in survivors. Preventative and chronic disease care are worse in long-term colorectal cancer survivors compared with breast cancer survivors. 

2) Compared with controls, cancer survivors had an increased consultation rate in the year after completion of treatment and in the year following discharge from hospital follow up. There was also an increase in consultations for pain and depression in the year following discharge from hospital follow up

Primary care issues
Implementation of the survivor care plan will assist primary care in providing more appropriate treatment for adult cancer survivors. However, risk stratification of needs, balancing cancer needs with those of co-morbidities and implementation of recall systems in primary care will be necessary to deliver optimum care.