NCRI 2015

The role of GPs in the cancer journey

Prof Greg Rubin - Durham University, Durham, UK

There’s a session on the role of primary care in cancer control. This is based on a commission that we did, that I led, for Lancet Oncology and which was published last month. The trigger for this commission was that, first of all, there’s an increasing demand for cancer care and there are more people being diagnosed with cancer, more people surviving cancer. And policy also is focussed more on care for patients being closer to where they live, delivered more commonly in the community than in hospital settings. So all of this made it quite timely for us to reconsider what evidence there was for the role of primary care in various stages of cancer from prevention and screening all the way through to survivorship and end of life care.

What evidence have you seen?

There’s a huge amount of evidence in whichever area you look. But there is evidence for the way in which involving GPs in screening can increase the uptake of screening for bowel cancer and for breast cancer. Obviously diagnosis and early diagnosis is a major policy imperative for many countries that are high income countries and primary care physicians, GPs in the UK, have a major role to play in that. We talk a great deal about the ways in which diagnosis can be made sooner by making better diagnostic facilities available to GPs. Then in survivorship there’s an obvious role for GPs with their more holistic approach, the way in which they provide continuing and comprehensive care to patients, a role for them in monitoring patients for the long term effects of cancers and cancer treatments. Then, of course, in end of life care GPs have always had an important role, in this country they have a very significant role. But better integration between palliative care specialists and GPs is something that we also call for and provide evidence for the effectiveness of.

What do you think the outcomes of that session will be?

I would hope that we expand awareness of the potential for general practice and primary care to contribute to cancer control in all of these aspects. I would hope that given the type of audience that we have here at NCRI we go beyond our usual constituency of people who make policy and people working in primary care and into the more specialist areas of oncology to gain a greater appreciation amongst oncologists of the opportunities that exist, particularly if we can generate a more integrated way of working to support these possibilities.

Any other thoughts on today’s session?

I’m hopeful that we get lots of people to the session and I’m optimistic that there will be a very stimulating debate. A lot of patients come to this conference and they will have a very important voice and view that I’m sure they’ll want to express.