The expanding role of primary care in cancer control - PubMed (original) (raw)

Review

. 2015 Sep;16(12):1231-72.

doi: 10.1016/S1470-2045(15)00205-3.

Annette Berendsen 2, S Michael Crawford 3, Rachel Dommett 4, Craig Earle 5, Jon Emery 6, Tom Fahey 7, Luigi Grassi 8, Eva Grunfeld 5, Sumit Gupta 9, Willie Hamilton 10, Sara Hiom 11, David Hunter 12, Georgios Lyratzopoulos 13, Una Macleod 14, Robert Mason 15, Geoffrey Mitchell 16, Richard D Neal 17, Michael Peake 18, Martin Roland 19, Bohumil Seifert 20, Jeff Sisler 21, Jonathan Sussman 22, Stephen Taplin 23, Peter Vedsted 24, Teja Voruganti 25, Fiona Walter 2, Jane Wardle 13, Eila Watson 26, David Weller 27, Richard Wender 28, Jeremy Whelan 29, James Whitlock 30, Clare Wilkinson 17, Niek de Wit 31, Camilla Zimmermann 32

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Review

The expanding role of primary care in cancer control

Greg Rubin et al. Lancet Oncol. 2015 Sep.

Abstract

The nature of cancer control is changing, with an increasing emphasis, fuelled by public and political demand, on prevention, early diagnosis, and patient experience during and after treatment. At the same time, primary care is increasingly promoted, by governments and health funders worldwide, as the preferred setting for most health care for reasons of increasing need, to stabilise health-care costs, and to accommodate patient preference for care close to home. It is timely, then, to consider how this expanding role for primary care can work for cancer control, which has long been dominated by highly technical interventions centred on treatment, and in which the contribution of primary care has been largely perceived as marginal. In this Commission, expert opinion from primary care and public health professionals with academic and clinical cancer expertise—from epidemiologists, psychologists, policy makers, and cancer specialists—has contributed to a detailed consideration of the evidence for cancer control provided in primary care and community care settings. Ranging from primary prevention to end-of-life care, the scope for new models of care is explored, and the actions needed to effect change are outlined. The strengths of primary care—its continuous, coordinated, and comprehensive care for individuals and families—are particularly evident in prevention and diagnosis, in shared follow-up and survivorship care, and in end-of-life care. A strong theme of integration of care runs throughout, and its elements (clinical, vertical, and functional) and the tools needed for integrated working are described in detail. All of this change, as it evolves, will need to be underpinned by new research and by continuing and shared multiprofessional development.

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