Delivering long-term cancer care in primary care
Dipesh P Gopal, Belle H. de Rooij, Nicole P. M. Ezendam, Stephanie Taylor
Abstract
In 2016, there were 17.2 million incident cases of cancer globally, and the number of incident cases increased by 28% in the preceding decade.1 Similar trends are anticipated in the UK, with 2.5 million people living with cancer in 2015, which is expected to increase to 4 million by 2030.2 Ten-year survival for all cancers has more than doubled in the UK from 24% to 50% over the last four decades.3 This is due to a combination of factors, including better diagnostic technology, screening programmes, and better treatments.1 Recovery after cancer and its treatment presents new challenges, including: physical problems, such as overwhelming fatigue; psychological problems, such as fear of recurrence; social problems, such as loss of employment; and the need for supplementary information. Primary care is well placed to provide proactive care to help with the interlinked biopsychosocial problems that may arise after the completion of cancer treatment. There is no clear consensus where the responsibilities for care of cancer survivors (those living with and beyond cancer; patients or clinicians do not universally adopt the term ‘survivorship’ as it implies a definite conclusion to treatment when this is not always clear) lie on the primary–secondary–tertiary healthcare continuum. According to the National Cancer Research Institute and James Lind Alliance, the top priority for living with and beyond cancer research is to answer the question, ‘What are the best models for delivering long-term cancer care, including screening, diagnosing, and managing long-term side effects and late effects of cancer and its treatment (for example, primary and secondary care, voluntary organisations, self-management, carer involvement, use of digital technology)?’ The recently published European guidelines4 for quality cancer care in primary care highlighted the need for more …