The role of general practitioners in German cancer care: a scoping review.

Abstract

General practitioners (GPs) play an important role in the care of patients with cancer across the entire cancer continuum, from diagnosis to palliative care. Despite their broad range of responsibilities, structures to facilitate the systematic involvement of GPs into cancer care remain insufficient in Germany. To date, the specific role and contribution of GPs within the German cancer care system have not been comprehensively synthesized. This scoping review aimed to summarize the available evidence on GP involvement in cancer care in Germany, including their roles across the cancer trajectory, collaboration with other healthcare providers, and barriers and needs affecting their participation in cancer care. A scoping review was conducted according to Arksey & O'Malley. The search was conducted on 2 January 2024 in the databases Cochrane Library, MEDLINE, and Web of Science. Eligible studies examined the role of GPs in the care of patients with cancer or long-term cancer survivors in Germany. Extracted review's domains (GPs' roles and responsibilities, collaboration, needs) were derived from an exploratory literature search and a GP advisory board. Findings were synthesized narratively. Studies published before 2008 were excluded. The search yielded 646 hits, of which 71 could be included in the full-text screening and 24 in the data extraction. GPs are involved in all phases of cancer care, including diagnosis, active treatment, follow-up care, and palliative care. GPs as "persons of trust" and experts in counselling, provide patient-centered cancer care and emotional support. GPs collaborate with other healthcare providers, but are rarely involved in specific treatment decisions. Deficiencies in communication, information exchange, and role clarification were identified. GPs expressed a need for greater involvement and better information through informal, bidirectional communication with various stakeholders in the oncology healthcare sector. Evidence on GP involvement in survivorship care and the management of comorbidities in patients with cancer was limited. Efficient structures for information exchange and knowledge transfer between GPs and other healthcare providers may support continuous and comprehensive care for patients with cancer. Future guidelines should explicitly address the role of GPs and provide clear recommendations for their integration into cancer care pathways. SCOPING REVIEW REGISTRATION: https://doi.org/10.17605/OSF.IO/T8XEN .