Barriers to satisfactory primary care contacts for Swedish cancer survivors: a cross-sectional survey.

The number of cancer survivors is increasing, but their health care needs are often unmet. Increased involvement of primary care has been suggested to address this. Several barriers to satisfactory primary care contacts for cancer survivors have been identified but little studied in a Swedish context. To explore barriers to satisfactory primary care contacts for Swedish cancer survivors, and factors associated with these barriers.

In 2023, patients in southern Sweden diagnosed with colorectal, lung, breast, or prostate cancer 1-2 or 5-6 years ago were invited to complete a digital questionnaire. The questionnaire covered quality of life, health problems, health care needs, and health care contacts. Respondents also rated the extent to which they had experienced six types of barriers to satisfactory primary care contacts. Logistic regression models were fitted to explore the relationship between barriers and other questionnaire variables.

A total of 8262 individuals were invited, and 2131 responded. Two-thirds (1429/2131; 67%) reported one or more barriers to satisfactory primary care contacts. Lack of staff continuity was most prevalent, with 48% (1031/2131) experiencing a barrier, followed by lack of access. Survivors with additional comorbidities, more cancer-related health problems, problem-induced primary care contacts, and those who lacked a regular primary care physician had higher odds of perceiving barriers than their counterparts.

This also applied to participants who did not have an active handover compared to those still in treatment. From the perspective of Swedish cancer survivors, improved relational continuity and access to primary care is needed.