Frequency and characteristics of cancer screening and follow-up in general practice: A French nationwide cross-sectional study

Abstract

Purpose General practitioners’ (GPs) roles about cancer are poorly documented. We therefore wished to describe cancer screening and follow-up activities carried out in general practice. Methods We used data from a French nationwide, multicenter, cross-sectional study, which described the distribution of health problems managed in general practice, along with the reasons for the encounter and the processes of care. We retrieved all the situations involving cancer screening and management from coded data and specific verbatims. Results Among 20,613 consultations recorded, 580 included cancer screening (2.8%) and 475 cancer follow-up (2.3%). The most frequent procedures performed for cancer screening were colorectal cancer screening tests (38.6% of screening procedures), genital examination (18.2%), cervical smear (16.8%), mammography (14.5%) and PSA test (9.3%). The most frequent cancers managed by GPs were breast (44.9%) and colorectal cancer (10.5%) in female patients, and prostate (37.3%) and skin cancer (10.3%) in male patients. The most frequent processes of care performed in cancer follow-up were medical examination (26.2% of care processes), drug prescription (19.8%), patient education/listening (12.6%), administrative procedures (8.7%) and discussion of test results (6.7%). Patients with cancer follow-up had on average 2.4 other health problems managed during the consultation. Patients screened and followed-up for cancer were less often low income patients (2.4% vs. 4.5% and 0.4% vs. 4.5%, respectively). Conclusions At least five percent of French general practice consultations include preventive or curative management of cancer and its comorbidities. GPs should pay special attention to reducing gender and economic health inequalities regarding cancer screening and follow-up.