Evidence map›Paper›PMID 19566990›Full record

SynthesisThe British journal of general practice : the journal of the Royal College of General Practitioners2009

Follow-up of cancer in primary care versus secondary care: systematic review.

Ruth A Lewis, Richard D Neal, Nefyn H Williams, Barbara France, Maggie Hendry, Daphne Russell, Dyfrig A Hughes, Ian Russell, Nicholas S A Stuart, David Weller and 1 more

Abstract readComparative StudySystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in The British journal of general practice : the journal of the Royal College of General Practitioners, 2009. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 83 papers, 13 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
83citing papers in PubMed, 13 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

83 citing papers in PubMed, 13 syntheses or guidelines pooled it.

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  7. Survivorship care for cancer patients in primary versus secondary care: a systematic review.Journal of cancer survivorship : research and practice · 2021
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  10. The role of the GP in follow-up cancer care: a systematic literature review.Journal of cancer survivorship : research and practice · 2016
    Pooled it
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  13. Patients' and healthcare professionals' views of cancer follow-up: systematic review.The British journal of general practice : the journal of the Royal College of General Practitioners · 2009
    Pooled it
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  20. Healthcare cost for non-hospital services and pharmaceuticals among breast cancer survivors: an event study.The European journal of health economics : HEPAC : health economics in prevention and care · 2026
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23 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

11 authors.

Ruth A LewisDepartment of Primary Care and Public Health, North Wales Clinical School, School of Medicine, Cardiff University, Wrexham. lewisr17@cf.ac.uk
Richard D Neal
Nefyn H Williams
Barbara France
Maggie Hendry
Daphne Russell
Dyfrig A Hughes
Ian Russell
Nicholas S A Stuart
David Weller
Clare Wilkinson

Funding

Cancer Research UK C8350/A4543
6 · The paper itself

Abstract

backgroundCancer follow-up has traditionally been undertaken in secondary care, but there are increasing calls to deliver it in primary care.

aimTo compare the effectiveness and cost-effectiveness of primary versus secondary care follow-up of cancer patients, determine the effectiveness of the integration of primary care in routine hospital follow-up, and evaluate the impact of patient-initiated follow-up on primary care. DESIGN OF STUDY: Systematic review.

settingPrimary and secondary care settings.

methodA search was carried out of 19 electronic databases, online trial registries, conference proceedings, and bibliographies of included studies. The review included comparative studies or economic evaluations of primary versus secondary care follow-up, hospital follow-up with formal primary care involvement versus conventional hospital follow-up, and hospital follow-up versus patient-initiated or minimal follow-up if the study reported the impact on primary care.

resultsThere was no statistically significant difference for patient wellbeing, recurrence rate, survival, recurrence-related serious clinical events, diagnostic delay, or patient satisfaction. GP-led breast cancer follow-up was cheaper than hospital follow-up. Intensified primary health care resulted in increased home-care nurse contact, and improved discharge summary led to increased GP contact. Evaluation of patient-initiated or minimal follow-up found no statistically significant impact on the number of GP consultations or cancer-related referrals.

conclusionWeak evidence suggests that breast cancer follow-up in primary care is effective. Interventions improving communication between primary and secondary care could lead to greater GP involvement. Discontinuation of formal follow-up may not increase GP workload. However, the quality of the data in general was poor, and no firm conclusions can be reached.

Indexed as

Ambulatory CareContinuity of Patient CareCost-Benefit AnalysisDelivery of Health CareFamily PracticeHumansNeoplasmsPatient SatisfactionPrimary Health CareRandomized Controlled Trials as Topic

Identifiers

PMID19566990
PMCPMC2702037

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.