The interface of primary and oncology specialty care: from symptoms to diagnosis.
Symptomatic individuals presenting to their primary care providers may need further evaluation and/or testing to determine whether a cancer is present. A number of issues arise in determining who needs further testing, what tests are needed, which specialists need to be involved, and how the testing can be organized and supported within a specific health-care system within a timely, coordinated, and cost-efficient manner. This article explores the challenges in the interface of primary care providers and specialists, includes evidence from prior research, and proposes research opportunities to understand and improve this phase of care.
Nekhlyudov
Larissa
L
Department of Population Medicine, Harvard Medical School, 133 Brookline Ave, 6th Floor, Boston, MA 02215, USA. larissa_nekhlyudov@vmed.org
Latosinsky
Steven
S
D001291:Attitude of Health Personnel; D057210:Delayed Diagnosis / Q000517:prevention & control; D003695:Delivery of Health Care; D019468:Disease Management; D055088:Early Detection of Cancer; D005260:Female; D005544:Forecasting; D019983:Guideline Adherence; D006302:Health Services Research; D006801:Humans; D033183:Interdisciplinary Communication; D007400:Interprofessional Relations; D008297:Male; D008495:Medical Oncology; D008962:Models, Theoretical; D009369:Neoplasms / Q000175:diagnosis* / Q000523:psychology; D010346:Patient Care Management; D010817:Physician-Patient Relations; D017410:Practice Guidelines as Topic; D011320:Primary Health Care
Br J Neurosurg. 2005 Aug;19(4):334-7
16455540
Eur J Surg Oncol. 2000 Aug;26(5):452-4
11016464
Adv Skin Wound Care. 2005 Jul-Aug;18(6):307-18
16096396
BMJ. 2007 Aug 11;335(7614):288
17631514
Chin J Dig Dis. 2006;7(1):24-32
16412034
Scand J Gastroenterol. 2007 Feb;42(2):228-36
17327943
Br J Cancer. 1999 May;80(3-4):427-37
10408849
Milbank Q. 2005;83(4):691-729
16279964
Br J Cancer. 2006 May 8;94(9):1272-80
16622459
Am Fam Physician. 2003 Nov 15;68(10):1983-6
14655807
Ann R Coll Surg Engl. 2008 Sep;90(6):517-22
18765032
J Natl Cancer Inst Monogr. 2010;2010(40):38-57
20386053
Postgrad Med J. 2002 Dec;78(926):748-51
12509694
J Fam Pract. 1997 Jul;45(1):47-53
9228914
J Clin Oncol. 2004 Mar 15;22(6):1126-35
15020615
Breast J. 1999 Jan;5(1):42-51
11348255
Intern Med J. 2005 Aug;35(8):491-6
16176475
Br J Gen Pract. 2004 Aug;54(505):611-3
15296562
Hautarzt. 1998 Nov;49(11):844-9
9879484
Evid Rep Technol Assess (Full Rep). 2006 Apr;(132):1-71
17627328
BMJ. 2005 Nov 12;331(7525):1121
16257992
Eur J Cancer Care (Engl). 2003 Dec;12(4):317-26
14982310
Breast J. 2008 Jul-Aug;14(4):353-6
18687070
Cancer Prev Control. 1999 Apr;3(2):137-44
10474761
BMC Health Serv Res. 2006 Apr 03;6:43
16584544
J Clin Oncol. 1995 Feb;13(2):502-12
7844612
JAMA. 2004 Jun 9;291(22):2705-12
15187051
Chest. 2006 Jan;129(1 Suppl):147S-153S
16428704
Colorectal Dis. 2006 May;8(4):289-95
16630232
N Engl J Med. 2009 Jul 23;361(4):368-78
19625717
Fam Pract. 1998 Oct;15(5):415-9
9848426
Cochrane Database Syst Rev. 2008 Jul 16;(3):CD004398
18646106
J Clin Oncol. 1998 Mar;16(3):1226-31
9508211
J Contin Educ Health Prof. 2002 Fall;22(4):222-9
12613057
Br J Dermatol. 2002 Jan;146(1):7-17
11841361
Gastrointest Endosc. 1999 Oct;50(4):480-5
10502167
BMC Womens Health. 2002 Nov 20;2(1):10
12443535
Can Fam Physician. 1999 Aug;45:1910-5
10463091
Oncologist. 2007 Jul;12(7):816-24
17673613
J Urol. 2004 Nov;172(5 Pt 1):1835-9
15540733
Am Fam Physician. 2008 Aug 1;78(3):347-52
18711950
Int J Qual Health Care. 2006 Sep;18 Suppl 1:45-51
16954516
Cancer Detect Prev. 2008;32(1):45-51
18406067
J Natl Cancer Inst Monogr. 2010;2010(40):58-71
20386054
Qual Saf Health Care. 2009 Oct;18(5):385-92
19812102
CA Cancer J Clin. 2002 May-Jun;52(3):134-49
12018928
JAMA. 1998 Sep 9;280(10):900-4
9739974
Aliment Pharmacol Ther. 2004 Nov 15;20(10):1045-52
15569106
World J Surg. 2005 Nov;29(11):1444-51
16240060
Can J Urol. 2008 Apr;15(2):3975-9
18405444
Can Fam Physician. 1999 Aug;45:1926-32
10463093
Semin Radiat Oncol. 2008 Jul;18(3):152-60
18513624
Fam Pract. 2004 Dec;21(6):605-11
15520035
Cancer Detect Prev. 2004;28(5):361-7
15542262
CMAJ. 1998 Feb 10;158 Suppl 3:S3-8
9484272
Int J Clin Pract. 2005 Nov;59(11):1334-9
16236089
Med Care. 2008 Oct;46(10):1108-15
18815533
J Clin Oncol. 2006 Apr 20;24(12):1877-82
16622262
Prev Med. 1996 Mar-Apr;25(2):218-24
8860288
J Surg Oncol. 2009 Jun 15;99(8):505-7
19072992
J R Soc Med. 1995 Jun;88(6):330-3
7629763
Can Fam Physician. 2003 Jul;49:882-6
12901484
Anticancer Res. 1996 Mar-Apr;16(2):995-9
8687166
N Engl J Med. 2008 Nov 13;359(20):2087, 2090
19005194
JAMA. 1998 Sep 9;280(10):905-9
9739975
Cochrane Database Syst Rev. 2008 Oct 08;(4):CD005471
18843691
BMJ. 2007 May 19;334(7602):1040
17493982
Ann Intern Med. 1999 Apr 20;130(8):651-7
10215561
Cochrane Database Syst Rev. 2000;(2):CD000349
10796531
Gastroenterology. 2006 Aug;131(2):390-401; quiz 659-60
16890592
N Engl J Med. 2008 Nov 13;359(20):2087, 2092
19005192
J Eval Clin Pract. 2002 Aug;8(3):319-25
12164978
J Natl Cancer Inst Monogr. 2010;2010(40):81-9
20386056
Am J Med. 2001 Dec 1;111(8):643-53
11755508
Int J Cancer. 2000 May 20;89(3):280-5
10861505
Arch Intern Med. 2002 Jun 24;162(12):1343-8
12076232
J Fam Pract. 2002 Mar;51(3):215-22
11978231
J Natl Cancer Inst. 2001 Apr 4;93(7):501-15
11287444
Eur J Cancer Care (Engl). 2005 Dec;14(5):409-16
16274461
Br J Gen Pract. 2002 Apr;52(477):284-9
11942444