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The role of the general practitioner during treatment and follow-up of patients with breast cancer

PhD ceremony:Ms C. (Carriene) Roorda-Lukkien
When:April 01, 2015
Start:12:45
Supervisors:prof. dr. G.H. (Truuske) de Bock, prof. dr. M.Y. (Marjolein) Berger
Co-supervisor:A.J. Berendsen
Where:Academy building RUG
Faculty:Medical Sciences / UMCG
The role of the general practitioner during treatment and follow-up
of patients with breast cancer

Women with a history of breast cancer need cancer surveillance, cancer screening, general medical care for comorbid conditions, and preventive health care. Until now, it is unclear which care provider - breast cancer specialists, general practitioners, nurses, or a combination of these - should be responsible for what component of survivorship care. This thesis describes the role of the general practitioner (GP) during treatment and follow-up care of patients with breast cancer. Moreover, this thesis explores perspectives of GPs and patients regarding the transfer of breast cancer follow-up to the primary care setting.

Results of two longitudinal studies on primary health care use, a quantitative mail survey among GPs, and a qualitative study among patients are presented. The increased primary health care use observed in this thesis suggests that Dutch GPs are already involved in care for female patients with breast cancer during the first year since diagnosis and the follow-up phase, although not in a formal way. However, results from the mail survey show that the implementation of long-term breast cancer follow-up care in Dutch general practice is not successful yet. Nevertheless, 40% of GPs would accept responsibility for follow-up care at an earlier stage (<5 years). Although most patients preferred specialist follow-up care to other models, more than half would accept GP-led follow-up care. Several strategies have been described to overcome the perceived difficulties and barriers among GPs and patients to implement/accept GP-led follow-up care. Future studies should provide a better understanding of Dutch specialists’ perspectives regarding this topic.