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Questioning specialists’ attitudes to breast cancer follow-up in primary care
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Donnelly, P., Hiller, Louise, Bathers, S., Bowden, S. and Coleman, R. (2007) Questioning specialists’ attitudes to breast cancer follow-up in primary care. Annals of Oncology, 18 (9). pp. 1467-1476. doi:10.1093/annonc/mdm193
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Official URL: http://dx.doi.org/10.1093/annonc/mdm193
Abstract
Background: National Institute for Clinical Excellence (NICE) guidelines recommend discharging asymptomatic breast care patients 3 years after diagnosis. A role for General Practitioners (GPs) and breast care nurses is proposed, together with skills training, but it remains unclear for how long breast cancer patients should be followed up, what tests should be done, and who should be conducting the follow-up. We therefore surveyed Breast Cancer Specialists. Design: A 20-point questionnaire was sent to 562 Specialists registered in the Cancer Research Clinical Trials Unit database, with questions on case-load, perceptions of follow-up, local policy and opinions on greater primary care involvement. Results: The most commonly acknowledged purpose of follow-up was detection of treatment-related morbidity. Eighty four percent of respondents adhered to a locally developed protocol with only 9% conforming to NICE guidelines. The median follow-up was 5 years. Significant factors predicting delayed discharge were younger age (P ≤ 0.0001); poorer Nottingham Prognostic Index (P = 0.003); treatment factors (P = 0.002); and patient risk factors (P = 0.003). Centres with higher case-loads (>200/year) were more likely to discharge earlier. Reduced workload was perceived as the main benefit of discharge, while lack of GP oncological experience and loss of outcome data were concerns. Conclusions: Specialists favour a risk adjusted discharge strategy and increased oncology infrastructure in primary care. © 2007 European Society for Medical Oncology.
| Item Type: | Journal Article | ||||||
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| Subjects: | R Medicine > RC Internal medicine > RC0254 Neoplasms. Tumors. Oncology (including Cancer) | ||||||
| Divisions: | Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School > Clinical Trials Unit Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School > Health Sciences Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School |
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| Journal or Publication Title: | Annals of Oncology | ||||||
| Publisher: | Oxford University Press | ||||||
| ISSN: | 0923-7534 | ||||||
| Official Date: | September 2007 | ||||||
| Dates: |
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| Volume: | 18 | ||||||
| Number: | 9 | ||||||
| Page Range: | pp. 1467-1476 | ||||||
| DOI: | 10.1093/annonc/mdm193 | ||||||
| Status: | Peer Reviewed | ||||||
| Publication Status: | Published | ||||||
| Access rights to Published version: | Restricted or Subscription Access |
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