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Integrated care for resected early stage lung cancer: innovations and exploring patient needs
  1. Jan Ho1,
  2. Annette McWilliams2,3,
  3. Jon Emery4,
  4. Christobel Saunders3,5,
  5. Christopher Reid6,
  6. Suzanne Robinson6 and
  7. Fraser Brims1,7
  1. 1 Department of Respiratory Medicine, Sir Charles Gairdner Hospital, Nedlands, Western Australia, Australia
  2. 2 Department of Respiratory Medicine, Fiona Stanley Hospital, Murdoch, Western Australia, Australia
  3. 3 School of Medicine and Pharmacology, University of Western Australia, Perth, Western Australia, Australia
  4. 4 General Practice and Primary Health Care Academic Centre, The University of Melbourne, Carlton, Victoria, Australia
  5. 5 Department of Surgery, Fiona Stanley Hospital, Perth, Western Australia, Australia
  6. 6 School of Public Health, Faculty of Health Sciences, Curtin University, Perth, Western Australia, Australia
  7. 7 Curtin Medical School, Faculty of Health Sciences, Curtin University, Perth, Western Australia, Australia
  1. Correspondence to Professor Fraser Brims; fraser.brims{at}


There is no consensus as to the duration and nature of follow-up following surgical resection with curative intent of lung cancer. The integration of cancer follow-up into primary care is likely to be a key future area for quality and cost-effective cancer care. Evidence from other solid cancer types demonstrates that such follow-up has no adverse outcomes, similar health-related quality of life, high patient satisfaction rates at a lower cost to the healthcare system. Core elements for successful models of shared cancer care are required: clear roles and responsibilities, timely effective communication, guidance on follow-up protocols and common treatments and rapid routes to (re)access specialist care. There is thus a need for improved communication between hospital specialists and primary care. Unmet needs for patients with early stage lung cancer are likely to include psychological symptoms and carer stress; the importance of smoking cessation may frequently be overlooked or underappreciated in the current hospital-based follow-up system. There is therefore a need for quality randomised controlled trials of patients with resected early stage lung cancer to establish optimal protocols for primary care-based follow-up and to more adequately address patients' and carers' unmet psychosocial needs, including the crucial role of smoking cessation.

  • carcinoma
  • non-small cell; thoracotomy; evaluation health services
  • primary health care

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  • Contributors JH drafted the initial manuscript, reviewed articles and submitted the manuscript for publishing. AMW, CS, CR, JE and SR provided opinions and revisions for the manuscript. FB drafted the final manuscript and did the corrections.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data sharing statement Not applicable.

  • Correction notice This paper has been amended since it was published Online First. Owing to a scripting error, some of the publisher names in the references were replaced with 'BMJ Publishing Group'. This only affected the full text version, not the PDF. We have since corrected these errors and the correct publishers have been inserted into the references.

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