The Role of Primary Care Physicians in Cancer Care
- 388 Downloads
The demand for oncology services in the United States (US) is increasing, whereas a shortage of oncologists looms. There is the need for a better understanding of the involvement of primary care physicians (PCPs) in cancer care.
To characterize the role of PCPs in cancer care, compare it with that of oncologists, and identify factors explaining greater PCP involvement in cancer care.
National survey of physicians caring for cancer patients conducted by the Cancer Care Outcomes Research and Surveillance Consortium.
1694 PCPs; 1621 oncologists.
Questionnaires mailed during 2005 and 2006 examined the participation of physicians in 12 aspects of care for cancer patients.
Over 90% of PCPs fulfilled general medical care roles for patients with cancer such as managing comorbid conditions, chronic pain, or depression; establishing do-not-resuscitate status; and referring patients to hospice. Oncologists were less involved in these roles. Determining the treatment preferences of individual patients and deciding on the use of surgery were the only cancer care roles in which ≥50% of PCPs participated. Twenty-two percent of PCPs reported no direct involvement in cancer care roles while 19% reported heavy involvement. PCPs who were aged ≥50 years, were internists or geriatricians, taught medical students, saw more cancer patients, or experienced referral barriers fulfilled more roles. Rural practice location was not associated with greater PCP involvement in cancer care.
PCPs across the US have an active role in cancer patient management. Determining the optimal interface between PCPs and oncologists in delivering and coordinating cancer care is an important area for future research.
KEY WORDSprimary care cancer treatment practice patterns health care delivery
This study was supported by grants from the National Cancer Institute to the CanCORS Statistical Coordinating Center and Primary Data Collection and Research Centers: U01 CA093344, U01 CA093332, U01 CA093324, U01 CA093348, U01 CA093329, U01 CA01013, U01 CA093326, and by a grant from the Department of Veteran’s Affairs to the Durham VA Medical Center, U01 CDA093344 (MOU) and HARO 03-438MO-03.
Conflict of Interest
- 1.Institute of Medicine. Fulfilling the Potential of Cancer Prevention and Early Detection. Washington, D.C.: National Academies Press; 2003.Google Scholar
- 2.American Cancer Society. Cancer Facts & Figures 2007. Atlanta: American Cancer Society; 2007.Google Scholar
- 15.National Cancer Institute. Cancer Care Outcomes Research and Surveillance Consortium. Last accessed June 22, 2009 at http://healthservices.cancer.gov/cancors/.
- 17.Little RJ, Rubin DB. Statistical Analysis with Missing Data. New York, NY: Wiley; 2002.Google Scholar
- 18.He Y, Zaslavsky AM. Imputation in a multiformat and multiwave survey of cancer care. Proceedings in Health Policy Statistics, American Statistical Association, 2007.Google Scholar
- 19.University of Washington Rural Health Research Center. Rural-Urban Commuting Area (RUCA) Codes. Last accessed June 22, 2009 at: http://depts.washington.edu/uwruca.
- 20.Institute of Medicine. From Cancer Patient to Cancer Survivor: Lost in Transition. Washington, D.C.: National Academies Press; 2006.Google Scholar
- 31.Institute of Medicine. Ensuring Quality Cancer Care. Washington, D.C.: National Academies Press; 1999.Google Scholar