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Is cancer a chronic disease? Comparison of health‐related quality of life and health care use in
cancer survivors and patients with a chronic disease.

Heins, M.J., Korevaar, J.C., Hopman, E.J.C., Donker, G.A., Schellevis, F.G. Is cancer a chronic disease? Comparison of health‐related quality of life and health care use in cancer survivors and patients with a chronic disease. Abstract. In: Abstract book 8th meeting of Ca-PRI 'The escalating cancer challenge - essential roles for primary care', 20-22 mei 2015, Aarhus. 97
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Background
The number of cancer survivors steadily increases. The long‐term planning of care in the survivorship phase necessitates a different approach than the short‐term planning in the treatment phase. Principles of disease management programs could provide an interesting perspective to improve care for cancer survivors. It would therefore be interesting to know in which aspects cancer survivors resemble patients with a chronic disease and in which aspects they differ.

Research question
Is health‐related quality of life (HRQoL) and health care use in cancer survivors similar to that of patients with a chronic disease?

Methods
1) Patients diagnosed above age 18 with a cancer type with a 5‐year survival rate >20% and no distant metastases at diagnosis
2) patients above age 18 with a physician diagnosed somatic chronic disease were sent a questionnaire.

HRQoL was measured with the SF‐36. Self‐reported health care use was measured for GP care, specialist care, rehabilitative care, physical therapy, ambulatory mental health care and occupational health care.

Results
We included 601 cancer survivors and 1052 patients with a chronic disease without cancer. 63% of the cancer survivors and 61% of the patients with a chronic disease were multimorbid. HRQoL of cancer survivors was significantly better than that of patients with a chronic disease, also after correction for age and sex. For the subscale ‘mental functioning’ we found no significant differences. Cancer survivors were less likely to visit a GP or cardiologist than patients with a chronic disease.

Conclusion
Considering their HRQoL and health care use, cancer survivors differ from patients with chronic disease. For cancer survivors without a chronic condition, who are generally in good physical health, a comprehensive disease management approach may not be necessary. However, many cancer survivors do have chronic diseases besides cancer and may benefit from patient‐centred proactive multidisciplinary care.