Cancer should be treated as a chronic condition within primary care to better support the rapidly growing population of cancer survivors, argues a new analysis.
As cancer treatments improve millions more people are living longer after diagnosis and require coordinated, long-term management similar to that offered for conditions such as diabetes, high blood pressure or asthma.
Around 3.5 million people in the UK are currently living after a cancer diagnosis, a figure expected to rise to 5.3 million by 2040, but post‑treatment support for survivors is fragmented and inconsistent across health systems.
A new analysis, led by Dr Rosalind Adam, Senior Clinical Lecturer at the University of Aberdeen’s School of Medicine, Medical Sciences and Nutrition, and published in the British Medical Journal makes the case that only thinking about cancer in terms of ‘curable’ or ‘incurable’ means important opportunities to promote and improve health after diagnosis are missed.
“There are no formal systems of long-term primary care cancer management in any European country,” explained Dr Adam.
“Lots of research has shown that people have unmet needs after cancer and yet very few solutions have been proposed. Re-conceptualising cancer as a long term condition would give people who wish it the opportunity for long-term pro-active primary care input after treatment.”
The researchers argue that cancer already meets standard definitions of a chronic disease in terms of having effects that can be long-term or arise years after treatment, complex factors that contribute to the development of cancer, and requirement for ongoing management - criteria recognised by bodies such as the World Health Organisation.
“Too many people finish treatment only to feel abandoned or unsure about what comes next,” added Dr Adam.
“Integrating cancer reviews into primary care would make support more consistent, more accessible and more personal, addressing ongoing health needs and reducing patients’ anxiety about navigating life after treatment.
The study recommends routine cancer reviews be delivered within existing chronic disease frameworks. It also calls for better coordination between cancer centres, GPs, charities and other community services; and improved recognition of survivors’ long-term physical, psychological and social needs.
“It’s time we acknowledge cancer as a chronic condition requiring routine, structured support - just like any other long-term illness.”
Further work is required to ascertain what roles primary care clinicians might have in delivering this step-change.
The research team included Dr David R Hogg, Professor Sir Lewis D Ritchie from the University of Aberdeen; and Professor Larissa Nekhlyudov from Harvard Medical School.
The analysis was funded through a personal research fellowship awarded to Dr Adam by the Chief Scientist Office of the Scottish Government (SCAF18/02).