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New study suggests connection between primary care and cancer survival
 
Posted on 2015/05/28

According to new research conducted by the International Cancer Benchmarking Partnership (ICBP) published in the BMJ Open today, a family physician's decision to investigate symptoms suggestive of cancer may be one of several factors contributing to differences in international cancer survival.

The study findings show that family physicians from Ontario are more likely to refer women presenting with symptoms suggestive of ovarian cancer for tests or to a specialist at their first visit than their peers in comparable jurisdictions, but are less likely to investigate people with symptoms suggestive of colorectal cancer. Ontario has the second highest one-year survival for ovarian cancer among the 11 jurisdictions participating in the study and ranks fourth for colorectal cancer.

The ICBP study was funded by the partners representing each jurisdiction, including Cancer Care Ontario. This research is the first of its kind to suggest a connection between primary care and differences in international cancer survival.

"The ICBP is a unique international partnership and Cancer Care Ontario is proud to contribute to this important initiative," says Dr. Linda Rabeneck, vice president of prevention and cancer control at Cancer Care Ontario. "While there are many factors that contribute to cancer survival, these findings clearly demonstrate that family physicians play a crucial role. In Ontario, we continue to develop evidence-based guidelines that help family physicians across the province provide the highest quality care for their patients with cancer or suspected cancer."

The study examined beliefs, behaviours and systems in primary care across six countries and 11 jurisdictions with similar healthcare systems, including New South Wales and Victoria (Australia), British Columbia, Manitoba, Ontario (Canada), England, Northern Ireland, Wales (United Kingdom), Denmark, Norway and Sweden. Researchers analysed survey responses from 2,795 family physicians between December 2012 and January 2013 in participating countries on how they would manage different patients presenting with symptoms suggestive of either lung, colorectal or ovarian cancer. These survey results were then mapped against one-year survival for those cancers in each jurisdiction or country.

A higher proportion of family physicians from Ontario reported having direct access to tests that can help investigate ovarian cancer, including an ultrasound, than to tests that can help investigate colorectal cancer, including colonoscopy. While this finding does not explain the association between a family physician's decision to investigate symptoms suggestive of cancer and survival, it does suggest that a family physician's access to tests may be a contributing factor that warrants further investigation.

"This research provides us with valuable new insights that help explain international differences in cancer survival," says Dr. Eva Grunfeld, principal investigator from Ontario and professor at the University of Toronto. "The findings call for further research on the connection between primary care and survival and also indicate how important it is for family physicians to have access to proper diagnostic tests. When cancer is detected in its early stages, it can be treated more effectively."

Additional findings:

  • Seventy-three per cent of family physicians from Ontario made a decision to refer women with symptoms suggestive of ovarian cancer for tests or to a specialist at their first visit, which is the highest proportion among all of the participating jurisdictions.

  • Approximately 50 per cent of family physicians from Ontario made the decision to refer people with symptoms suggestive of lung cancer for tests or to a specialist at their first visit, which is similar to the other participating jurisdictions.
  • Approximately 25 per cent of family physicians from Ontario made the decision to refer people with symptoms suggestive of colorectal cancer for tests or to a specialist at their first visit, which was lower than the top performing jurisdictions.
  • Less than 20 per cent of family physicians from Ontario reported having direct access to flexible sigmoidoscopy and colonoscopy, which are used to help investigate colorectal cancer. This is lower than the top performing jurisdictions.
  • Family physicians reported total wait times for colonoscopy and flexible sigmoidoscopy in Ontario were between seven and eight weeks, which is longer than the top performing jurisdictions. Ontario ranked sixth and eighth among the 11 jurisdictions for flexible sigmoidoscopy and colonoscopy total wait times, respectively.

For further information, please see the backgrounder.

About Cancer Care Ontario:

Cancer Care Ontario (CCO) — an Ontario government agency — drives quality and continuous improvement in disease prevention and screening, the delivery of care and the patient experience for cancer and chronic kidney disease patients. Known for its innovation and results-driven approaches, CCO leads multi-year system planning, contracts for services with hospitals and providers, develops and deploys information systems, establishes guidelines and standards and tracks performance targets to ensure system-wide improvements in cancer and chronic kidney disease care.

About the International Cancer Benchmarking Partnership (ICBP):

The International Cancer Benchmarking Partnership (ICBP) is a unique and innovative global partnership of clinicians, academics and policymakers. The ICBP is funded by the partners representing each jurisdiction, including Cancer Care Ontario. Cancer Research UK manages the partnership. More information is available at www.icbp.org.uk.

For more information, please contact:

Erin MacFarlane, Cancer Care Ontario
Phone: 1.855.460.2646
Email: media@cancercare.on.ca

Paul Thorne, Cancer Research UK
Phone: 020.3469.8352
Email: press.office@cancer.org.uk

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Last modified: Thu, May 28, 2015
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