Background: Primary care providers (PCPs) have always played an important role in cancer diagnosis. There is\nincreasing awareness of the importance of their role during treatment and survivorship. We examined changes in\nPCP utilization from pre-diagnosis to survival for women diagnosed with breast cancer, factors associated with\nbeing a high user of primary care, and variation across four Canadian provinces.\nMethods: The cohorts included women 18+ years of age diagnosed with stage I-III invasive breast cancer in years\n2007â??2012 in British Columbia (BC), Manitoba (MB), Ontario (ON), and Nova Scotia (NS) who had surgery plus\nadjuvant chemotherapy and were alive 30+ months after diagnosis (N = 19,589). We compared the rate of PCP visits\nin each province across phases of care (pre-diagnosis, diagnosis, treatment, and survival years 1 to 4).\nResults: PCP use was greatest during treatment and decreased with each successive survival year in all provinces.\nThe unadjusted difference in PCP use between treatment and pre-diagnosis was most pronounced in BC where\nPCP use was six times higher during treatment than pre-diagnosis. Factors associated with being a high user of\nprimary care during treatment included comorbidity and being a high user of care pre-diagnosis in all provinces.\nThese factors were also associated with being a higher user of care during diagnosis and survival.\nConclusions: Contrary to the traditional view that PCPs focus primarily on cancer prevention and early detection,\nwe found that PCPs are involved in the care of women diagnosed with breast cancer across all phases of care.
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