General practictioners' management of cancer in England: secondary analysis of data from the National Survey of NHS Patients - Cancer

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Abstract
Relatively little is understood concerning the exact role of general practice in the cancer patients' pre-diagnostic, and post-diagnostic journey. This paper aims to explore this role using data from the National Survey of NHS Patients-Cancer. Data from 65,192 patients relating to five questions from this survey were analysed in detail with particular relevance to differences between the six cancers [breast, colorectal, lung, ovarian, prostate and non-Hodgkin's lymphoma (NHL)], and socio-demographic variables (age, gender and social class). There were considerable differences between patients with the six cancers, and the role of general practice in the cancer diagnosis, and post-diagnosis management. The vast majority of patients saw their general practitioner (GP) with symptoms prior to being seen in hospital. A significant minority were told their diagnosis by their GP. About half the sample were told to contact their GP post-discharge, and about half did so. Being told to contact the GP post-discharge was strongly associated with actually seeing the GP. Most patients felt that their GP was given enough information about their treatment or condition. In conclusion, this work has quantified the central role of general practice in cancer diagnosis and management in England. There remain considerable resource, educational and research needs to continue to provide high-quality cancer care in primary care.