A new study published in the Journal of Primary Health Care shows that GPs should be involved in all stages of New Zealander’s cancer care for patients to have the best chance of success.
One in three New Zealanders who get cancer can be cured now if their disease is found and treated in time, which means more people are living as cancer survivors, or living with cancer as a long-term condition, similar to something like diabetes, which needs to be managed by their GP.
General practice is an essential part of cancer care as it is directly involved in all stages of the cancer continuum. However, because patients will often get their active cancer care (e.g. chemotherapy, radiation, surgery) through secondary care without the involvement of their GP, when they’re discharged back into the care of their usual doctor, they may be uncertain about who is responsible for ongoing cancer-related care.
The break in continuity of cancer care creates uncertainty for patients and GPs about who is responsible for ongoing cancer-related care.
"We showed in this study that while the prevalence of cancer in Māori was only slightly higher than non-Māori patients, the 10 year rate was significantly higher for Maori when adjusted for their younger age at presentation."
Dr Rawiri Keenan, College Fellow and author of the study.
The College’s medical director Dr Bryan Betty says, "Cancer survivors are at risk of cancer recurrence and need a strong relationship with their GP to ensure continuity of appropriate care.
"Cancer now is a survivable, long-term condition for many and to suitably deliver that level of care we need Government to understand that cancer care is happening in the community, which means funding general practice for the delivery of those services.
"Patients also need clearer connections between primary and secondary care to have the best chance, especially because cancer disproportionately affects the elderly, who are more likely to have comorbidities, which requires greater, more complex care on a more regular basis."
Dr Rawiri Keenan (pictured above), an author of the study and Fellow of the College says, "We showed in this study that while the prevalence of cancer in Māori was only slightly higher than non-Māori patients, the 10 year rate was significantly higher for Maori when adjusted for their younger age at presentation.
"Cancer now is a survivable, long-term condition for many and to suitably deliver that level of care we need Government to understand that cancer care is happening in the community, which means funding general practice for the delivery of those services"
Dr Bryan Betty, College Medical Director.
"This lines up with other studies reporting that both the incidence and survival of many cancers are disproportionally worse for Māori. Māori patients were less likely to be under usual follow-up care from their GP but more likely to be receiving active treatment," said Dr Keenan.
General practice has an increasing workload and place in cancer care because advances in treatment mean people are living longer and regular screening programmes mean people are being diagnosed earlier in their cancer, meaning curative treatment is more likely.
Several other studies do report that a good relationship between GP and patient is essential for speeding up cancer diagnosis.
The study ‘Prevalence of invasive cancer in a large general practice patient population in New Zealand’ was the first of its kind to look at the cancer prevalence using primary care data. It took data from 11,374 patients from a large general practice in a medium-sized Waikato town.
When compared to the National Cancer Registry, it gave no more information about the prevalence of cancer but showed the complex ongoing care general practice provides to patients with cancer e.g. comorbidity conditions and psychological support The Journal of Primary Health Care is a medical research journal published by The Royal New Zealand College of General Practitioners.
Access the report: https://www.publish.csiro.au/HC/HC19113