title: The combined effect of cancer and chronic diseases on general practitioner consultation rates.
abstract: OBJECTIVE
  More than two-thirds of cancer patients have one or more chronic diseases besides cancer. The purpose of this study was to get detailed insight into the combined effect of cancer and chronic diseases on general practitioner (GP) consultation rates.
  
  
  METHODS
  From the NIVEL Primary Care Database we identified cancer patients with diabetes mellitus (n=629), osteoarthritis (n=425), coronary artery disease (n=466), COPD (n=383) or without a chronic disease (n=1507), diagnosed with cancer between 2002 and 2010. They were matched on sex, age, practice and chronic disease to 6645 non-cancer controls.
  
  
  RESULTS
  2-5 years after diagnosis, cancer patients without a chronic disease had on average 6.5 GP contacts per year, those with a comorbid disease almost twice as many (ranging from 10 for osteoarthritis to 12.4 for COPD). A similar difference was seen in non-cancer controls. The number of GP contacts for chronic diseases did not differ between cancer patients and controls. The increase in the number of GP consultations with age and number of chronic diseases was similar in cancer patients and controls. Consultation rates were similar in cancer patients and controls if they were stratified by number of chronic diseases while counting cancer as a chronic disease.
  
  
  CONCLUSIONS
  Two to five years after diagnosis, cancer leads to an increase in GP contacts that is similar to having a chronic disease. This increase does not differ between those with and without a chronic disease and cancer does not seem to increase the impact of having a chronic disease.
authors.affiliation: Netherlands Institute for Health Services Research (NIVEL), Utrecht, The Netherlands. Electronic address: m.heins@nivel.nl.
authors.forename: M J Marianne
authors.initials: MJ
authors.lastname: Heins
authors.affiliation: Netherlands Institute for Health Services Research (NIVEL), Utrecht, The Netherlands.
authors.forename: J C Joke
authors.initials: JC
authors.lastname: Korevaar
authors.affiliation: Netherlands Institute for Health Services Research (NIVEL), Utrecht, The Netherlands.
authors.forename: G A Gé
authors.initials: GA
authors.lastname: Donker
authors.affiliation: Netherlands Institute for Health Services Research (NIVEL), Utrecht, The Netherlands.
authors.forename: P M Mieke
authors.initials: PM
authors.lastname: Rijken
authors.affiliation: Netherlands Institute for Health Services Research (NIVEL), Utrecht, The Netherlands; Department of General Practice/EMGO Institute for Health and Care Research, VU University Medical Centre, Amsterdam, The Netherlands.
authors.forename: F G François
authors.initials: FG
authors.lastname: Schellevis
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002908:Chronic Disease; D016208:Databases, Factual; D005260:Female; D005500:Follow-Up Studies; D058005:General Practitioners / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000453:epidemiology / Q000628:therapy*; D011320:Primary Health Care / Q000706:statistics & numerical data*
keywords: Cancer; Chronic disease; Comorbidity; General practice; Health care use; Primary care