The role of primary care physicians in cancer care.
BACKGROUND
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.


OBJECTIVE
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.


METHODS
National survey of physicians caring for cancer patients conducted by the Cancer Care Outcomes Research and Surveillance Consortium.


METHODS
1694 PCPs; 1621 oncologists.


METHODS
Questionnaires mailed during 2005 and 2006 examined the participation of physicians in 12 aspects of care for cancer patients.


RESULTS
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 > or =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 > or =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.


CONCLUSIONS
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.
Klabunde
Carrie N
CN
Applied Research Program, Division of Cancer Control and Population Sciences, National Cancer Institute, EPN 4005; 6130 Executive Boulevard, Bethesda, MD 20892-7344, USA. KlabundC@mail.nih.gov
Ambs
Anita
A
Keating
Nancy L
NL
He
Yulei
Y
Doucette
William R
WR
Tisnado
Diana
D
Clauser
Steven
S
Kahn
Katherine L
KL
D000328:Adult; D000368:Aged; D001291:Attitude of Health Personnel; D003266:Continuity of Patient Care / Q000639:trends; D003625:Data Collection / Q000379:methods; D005260:Female; D006801:Humans; D008297:Male; D008495:Medical Oncology / Q000379:methods / Q000639:trends; D008875:Middle Aged; D009369:Neoplasms / Q000628:therapy*; D010819:Physician's Role; D010817:Physician-Patient Relations; D010821:Physicians, Family / Q000639:trends