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Increased health care use in cancer survivors.

Heins, M.J., Rijken, P.M., Schellevis, F.G., Hoek, L. van der, Korevaar, J.C. Increased health care use in cancer survivors. Abstract. 36ste WEON 'Health and disease during the life course', 14-15 juni 2012, Rotterdam.
Background: As the number of cancer survivors increases and these patients often experience long-lasting consequences of cancer and its treatment, more insight into primary health care use of cancer survivors is needed. We aimed to determine how often and for which reasons do adult cancer patients contact their Primary Care Physician (PCP) 2-5 years after diagnosis. Methods: Using data from the Netherlands Information Network of Primary Care (LINH), we determined the volume and diagnoses made during primary health care contacts in 1,056 adult breast cancer patients, 419 prostate cancer patients and 400 colorectal cancer patients, two to five years after diagnosis and compared this to age and sex matched controls from the same practice. Results: The number of contacts with the GP was significantly higher in cancer patients: 24% in breast cancer patients, 33% in prostate cancer patients and 15% in patients with colorectal cancer. This difference was most prominent in younger patients without a chronic disease. The mean number of contacts specifically related to cancer was 0.4 (SD 1.7) per year for breast cancer patients, 0.7 (SD 2.2) per year for prostate cancer patients and 0.6 (SD 4.3) per year for patients with colorectal cancer. When looking at the diagnoses made during contacts with the PCP, patients contacted their PCP more often for acute symptoms, such as cough and abdominal pain, and for infections, such as cystitis and respiratory infections. Breast cancer patients had more diabetes related contacts and contacted their PCP more often with sleep disturbance and depression. Prostate cancer patients had more contacts related to hypertension and COPD. Adverse effects of medical agents were also more often recorded in cancer patients. Conclusions: Primary health care use is significantly increased two to five years after diagnosis of cancer. This is mostly related to infections and acute symptoms.