Jon Emery1, Peter Nguyen2, Jesse Minshall3, Kara-Lynne Cummings4, Jennifer Walker5. 1. MA, MBBCh, FRACGP, MRCGP, DPhil,zzm321990Herman Professor of Primary Care Cancer Research,zzm321990Centre for Cancer Research and Department ofzzm321990General Practice, Faculty of Medicine, Dentistry andzzm321990Health Sciences, University of Melbourne, Vic.zzm321990jon.emery@unimelb.edu.au 2. BBiomed(Hons) student, Centrezzm321990for Cancer Research and Department of Generalzzm321990Practice, Faculty of Medicine, Dentistry and Healthzzm321990Sciences, University of Melbourne, Vic 3. MD, BSc, medical intern, Westernzzm321990Health, Footscray, Vic 4. BA, PC4 Project Officer,zzm321990Centre for Cancer Research and Department ofzzm321990General Practice, Faculty of Medicine, Dentistry andzzm321990Health Sciences, University of Melbourne, Vic 5. BAppSci, MPH, PhD, Seniorzzm321990Research Fellow, Centre for Cancer Research andzzm321990Department of General Practice, Faculty of Medicine,zzm321990Dentistry and Health Sciences, University ofzzm321990Melbourne, Vic
Abstract
Background: Prevention of cancer in primary care has focused on modifying behaviours associated with increased risk of cancer (primary prevention) or increasing participation in national cancer screening programs (secondary prevention). On the basis of metaanalyses of large prevention trials, a new paradigm in primary prevention – chemoprevention – is beginning to enter the realms of primary care for specific populations. Objectives: In this article, we discuss two examples of cancer chemoprevention relevant to general practice: low-dose aspirin for the prevention of colorectal cancer in people aged 50–70 years, and selective oestrogen receptor modulators (SERMs) for women at increased risk of breast cancer. We present new expected frequency trees that show the absolute benefits and harms of taking these medications in specific populations. Discussion: These expected frequency trees can serve as risk-communication aids to support shared decision making and the implementation of new chemoprevention guidelines in general practice.
Background: Prevention of cancer in primary care has focused on modifying behaviours associated with increased risk of cancer (primary prevention) or increasing participation in national cancer screening programs (secondary prevention). On the basis of metaanalyses of large prevention trials, a new paradigm in primary prevention – chemoprevention – is beginning to enter the realms of primary care for specific populations. Objectives: In this article, we discuss two examples of cancer chemoprevention relevant to general practice: low-dose aspirin for the prevention of colorectal cancer in people aged 50–70 years, and selective oestrogen receptor modulators (SERMs) for women at increased risk of breast cancer. We present new expected frequency trees that show the absolute benefits and harms of taking these medications in specific populations. Discussion: These expected frequency trees can serve as risk-communication aids to support shared decision making and the implementation of new chemoprevention guidelines in general practice.
Authors: Peter Nguyen; Jennifer McIntosh; Adrian Bickerstaffe; Sanjaya Maddumarachchi; Kara-Lynne Cummings; Jon D Emery Journal: Br J Gen Pract Date: 2019-11-28 Impact factor: 5.386