Marie-Eve Rougé Bugat1,2,3, Christelle Omnes4, Cyrille Delpierre5, Emile Escourrou4, Nathalie Boussier4, Stéphane Oustric4,6, Jean-Pierre Delord7, Eric Bauvin8, Pascale Grosclaude5,9. 1. University Department of General Practice, Toulouse-Rangueil Faculty of Medicine, 133 route de Narbonne, 31400, Toulouse, France. marieeve.rouge-bugat@dumg-toulouse.fr. 2. Inserm U1027, Faculty of Medicine, 37 allées Jules Guesde, 31073, Toulouse, France. marieeve.rouge-bugat@dumg-toulouse.fr. 3. Doctor's office, 59 rue de la Providence, 31500, Toulouse, France. marieeve.rouge-bugat@dumg-toulouse.fr. 4. University Department of General Practice, Toulouse-Rangueil Faculty of Medicine, 133 route de Narbonne, 31400, Toulouse, France. 5. Inserm U1027, Faculty of Medicine, 37 allées Jules Guesde, 31073, Toulouse, France. 6. Doctor's office, 59 rue de la Providence, 31500, Toulouse, France. 7. University Department of Oncology, Toulouse University Cancer Institute IUCT-Oncopole, 1 avenue Irène Joliot-Curie, 31059, Toulouse Cedex 9, France. 8. Regional Cancer Network Oncomip, IUCT-Oncopole, 1 avenue Irène Joliot-Curie, 31059, Toulouse Cedex 9, France. 9. Cancer Registry of the Tarn, BP 37, 81000, Albi, France.
Abstract
PURPOSE: The primary care physician (PCP) is central to cancer patients' management. Announcement of the diagnosis is a critical time for patients, even if they wish to be fully informed. The French National Cancer Plan, developed 10 years ago, includes a diagnosis disclosure procedure (DDP) to be used by oncologists, which makes specific provision for a time of communication with PCPs. So, we asked PCPs about their role in cancer announcement since the launching of the DDP. METHODS: A cross-sectional prospective study by postal questionnaire was sent to 500 PCPs in the largest region of France. It addressed (1) the characteristics of cancer disclosure, (2) PCPs' source of information of the diagnosis, (3) time of disclosure, (4) information exchange, and (5) the physicians' knowledge of the DDP. RESULTS: The response rate was 48 %. In 20 % of cases, oncologists delegated the announcement to PCPs. In 19 % of cases, it was the patient or their family who informed the PCP of the diagnosis. We identified three announcement phases of cancer diagnosis in the physicians' clinical practice: pre-disclosure, disclosure, and repeat disclosure. In 57 % of cases, PCPs lacked information on prognosis and in 60 % on treatment. Regarding the DDP, nearly half of PCPs did not know the procedure itself or its content. CONCLUSION: PCPs announce the cancer diagnosis, even if they have not received the necessary information to do so. The DDP needs to be adapted for use in primary care practice.
PURPOSE: The primary care physician (PCP) is central to cancerpatients' management. Announcement of the diagnosis is a critical time for patients, even if they wish to be fully informed. The French National Cancer Plan, developed 10 years ago, includes a diagnosis disclosure procedure (DDP) to be used by oncologists, which makes specific provision for a time of communication with PCPs. So, we asked PCPs about their role in cancer announcement since the launching of the DDP. METHODS: A cross-sectional prospective study by postal questionnaire was sent to 500 PCPs in the largest region of France. It addressed (1) the characteristics of cancer disclosure, (2) PCPs' source of information of the diagnosis, (3) time of disclosure, (4) information exchange, and (5) the physicians' knowledge of the DDP. RESULTS: The response rate was 48 %. In 20 % of cases, oncologists delegated the announcement to PCPs. In 19 % of cases, it was the patient or their family who informed the PCP of the diagnosis. We identified three announcement phases of cancer diagnosis in the physicians' clinical practice: pre-disclosure, disclosure, and repeat disclosure. In 57 % of cases, PCPs lacked information on prognosis and in 60 % on treatment. Regarding the DDP, nearly half of PCPs did not know the procedure itself or its content. CONCLUSION: PCPs announce the cancer diagnosis, even if they have not received the necessary information to do so. The DDP needs to be adapted for use in primary care practice.
Entities:
Keywords:
Announcement; Cancer; Diagnosis disclosure procedure; Disclosure; General practice; National Cancer Plan
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