Expanding role of family physician’s team in early cancer detection for multimorbid patients

Aurimas Rapalavičius, Leonas Valius, Ida Liseckienė, Gediminas Urbonas, Juratė Ezelskienė, Olga Vasiliauskienė, Aiste Česnulevičienė, Laimutis Gedminas

Keywords: multimorbidity; early cancer detection; primary care; family physician's team

Cancer (Ca) is ranked number 10 among patients with Multimorbidity (MM)in Lithuania. MM negatively affects patients’ participation in Ca screening, provides a challenge to timely diagnosis and is associated with advanced stages of Ca.
Primary care is crucial for timely diagnosis but complexity of symptoms, especially in MM patients, result in delayed or reluctant approach in pursuit for Ca diagnosis. Therefore, a progressive and holistic approached is necessary for early Ca detection and management in MM patients.
Aiming to provide better quality and accessibility of care to patients with MM,“Telelispa” project, funded by EU, will be carried out in the period of 2020-2022 in Lithuania with one of the research objects being to evaluate family physician’s team (FPT) progressive and holistic approach benefits and capabilities in early Ca detection.

Research questions:
How FPT’s progressive and holistic approach to early Ca detection may
affect the diagnosed stage of Ca?

385 patients with MM and 385 in control group from 7 different primary health care settings (urban and rural) will be included in the “Telelispa” project, which is based on Chrodis Plus. Holistic evaluation for MM patients will be performed by FPT, consisting of family physician and a case manager, as follows:
• complete audit of performed national Ca screening programs: prostate, cervical, colorectal and breast Ca.
• expanded evaluation of risk factors and family history of Ca and physical examination, including teledermatoscopy.
• review or assigning tests if not done per year (based on country’s Family medicine norm): blood analysis (for anemia), chest X-ray and abdominal ultrasound for possible corresponding Ca.
• FPT’s progressive and holistic approach will be assessed by comparing diagnosed Ca stages with control group and national average stages of corresponding Ca

Ongoing project. The results of the project will be used for a set of recommendations.

Ongoing project.

Points for discussion:
What national guidelines do other countries have for early Ca detection in primary care?

How progressive and holistic approach can affect the landscape of early Ca detection?