The role of primary care in the cancer care continuum: a qualitative study of cancer survivors’ experiences

OBJECTIVE: To explore how cancer survivors have experienced their contacts with primary care after being diagnosed with cancer, focusing on the integration between cancer specialist and primary care, and participants’ views on what could make primary care services better at catering to the needs of cancer survivors. DESIGN: A qualitative study in which data was collected through semi-structured digital focus group interviews and analyzed using a template analysis approach. SETTING AND SUBJECTS: Adult residents of Skåne, Sweden, who had been diagnosed with and initiated treatment for either of five common cancer forms, recruited through patient advocacy groups. MAIN OUTCOME MEASURES: A qualitative description of participants’ experiences and perceptions as expressed in focus group interview data. RESULTS: Most participants felt that primary care services had not played a significant role for them, despite patterns of both increased and unmet health needs. Insufficient coordination and communication with specialist cancer care, low availability, lacking personal continuity, low cancer competence and lacking commitment to cancer-related needs were presented as barriers to satisfactory primary care. A strengthened bond between cancer and primary care services, privileged access, and holistic perspectives were all suggested as measures to make primary care more suitable to cancer survivors’ needs. CONCLUSION: The study suggests that cancer survivors experience a range of issues that hinders primary care services from playing a productive role in the cancer care process. The results speak for a need for interventions to remove barriers to satisfactory primary care contacts in this group of patients. KEY POINTS: The growing number of cancer survivors highlights the role of primary care services in the cancer care continuum. Despite the presence of unmet needs, few cancer survivors felt that primary care services had been significant to their care. Survivors identified a number of barriers to satisfactory primary care, including lacking coordination and communication between cancer and primary care. Strengthened links between healthcare services, privileged access, and holistic perspectives were suggested to improve primary care delivery for cancer survivors.