Oncologie in de huisartsenpraktijk.

Aim: The incidence of cancer is increasing and treatments are getting better. General practitioners are increasingly seeing patients with a history of cancer. This article provides an overview of the impact of malignancy in general practice. Method: Using data from the National Information Network of General Practitioners (LINH), we determined the incidence of the 10 most frequently occuring cancers in the period 2002–2010, as well as the number of times patients contacted their general practitioner in the first 2 years after diagnosis. The LINH is a nationally representative network of 84 general practices with more than 335,000 patients. Results: The average general practice had 73 adult patients with cancer diagnosed less than 9 years ago, and in 33 of these patients cancer was diagnosed less than 2 years ago. In the first 2 years after diagnosis, patients made on average 11 visits to their general practitioner annually, and the number of visits increased with age. On an annual basis, two to three visits were associated with the cancer diagnosis, three were associated with common symptoms, one was associated with infections, and less than one with psychosocial problems. For comparison, Dutch adults (> 18 years) saw their general practitioners on average four times a year, less than half the number of times cancer patients did. Conclusion: Given the expected increase in the number of patients with cancer, the greater need for care of these patients, and the potential shift of oncological care from secondary to primary care, patients with cancer will account for an increasing proportion of the workload of general practitioners in the near future. It is important that all those concerned anticipate to the extra demand for care in time. (aut. ref.