title: Review of guidance on recurrence risk management for general practitioners in breast cancer, colorectal cancer and melanoma guidelines.
abstract: General practitioners (GPs) will face cancer recurrences more frequently due to the rising number of cancer survivors and greater involvement of GPs in the follow-up care. Currently, GPs are uncertain about managing recurrence risks and may need more guidance.
  
  
  
  To explore what guidance is available for GPs on managing recurrence risks for breast cancer, colorectal cancer and melanoma, and to examine whether recurrence risk management differs between these tumour types.
  
  
  
  Breast cancer, colorectal cancer and melanoma clinical practice guidelines were identified via searches on internet and the literature, and experts were approached to identify guidelines. Guidance on recurrence risk management that was (potentially) relevant for GPs was extracted and summarized into topics.
  
  
  
  We included 24 breast cancer, 21 colorectal cancer and 15 melanoma guidelines. Identified topics on recurrence risk management were rather similar among the three tumour types. The main issue in the guidelines was recurrence detection through consecutive diagnostic testing. Guidelines agree on both routine and nonroutine tests, but, recommended frequencies for follow-up are inconsistent, except for mammography screening for breast cancer. Only six guidelines provided targeted guidance for GPs.
  
  
  
  This inventory shows that recurrence risk management has overlapping areas between tumour types, making it more feasible for GPs to provide this care. However, few guidance on recurrence risk management is specific for GPs. Recommendations on time intervals of consecutive diagnostic tests are inconsistent, making it difficult for GPs to manage recurrence risks and illustrating the need for more guidance targeted for GPs.
authors.affiliation: NIVEL, Netherlands Institute for Health Services Research, Utrecht, The Netherlands.
authors.forename: Inge
authors.initials: I
authors.lastname: Spronk
authors.affiliation: NIVEL, Netherlands Institute for Health Services Research, Utrecht, The Netherlands.
authors.forename: Joke C
authors.initials: JC
authors.lastname: Korevaar
authors.affiliation: Dutch College of General Practitioners, Utrecht, The Netherlands.|School CAPHRI, Department Family Medicine, Maastricht University, Maastricht, The Netherlands.
authors.forename: Jako S
authors.initials: JS
authors.lastname: Burgers
authors.affiliation: Centre for Health System Analyses, National Institute of Public Health, Ljubljana, Slovenia.
authors.forename: Tit
authors.initials: T
authors.lastname: Albreht
authors.affiliation: NIVEL, Netherlands Institute for Health Services Research, Utrecht, The Netherlands.|Department of General Practice & Elderly Care Medicine/EMGO Institute for health and care research, VU University Medical Center, Amsterdam, The Netherlands.
authors.forename: François G
authors.initials: FG
authors.lastname: Schellevis
mesh_terms: D001943:Breast Neoplasms / Q000175:diagnosis* / Q000628:therapy; D015179:Colorectal Neoplasms / Q000175:diagnosis* / Q000628:therapy; D005194:Family Practice; D005260:Female; D058005:General Practitioners / Q000193:education*; D006801:Humans; D008327:Mammography; D008545:Melanoma / Q000175:diagnosis* / Q000628:therapy; D009364:Neoplasm Recurrence, Local; D017410:Practice Guidelines as Topic; D010818:Practice Patterns, Physicians' / Q000592:standards; D012308:Risk Management
keywords: Breast neoplasms; colorectal neoplasms; general practitioners; guidelines; melanoma; recurrence