Ietje Perfors

35 other hand, as these participants might be more critical, their needs might be higher and less easy to meet. Themain strength of this study is the high number of (former) cancer patients who responded to this survey. The large population and the variety of cancer types support generalisability and enabled sub-group explorations. Comparison with existing literature To our knowledge, this is the first study among cancer patients that combines an exploration of the needs for GP involvement in cancer care and specifically in SDM, and to what extent these needs are met. Our findings are in line with the few studies that have addressed adjacent topics. It confirms the conclusion of Halkett et al., who reported that patients see a role for the GP in SDM support after a cancer diagnosis. 10 Lang et al. reported that 34.5% of the cancer patients discussed diagnostic and therapy related decisions with the GP. 9 Also, Klabunde et al. showed that 64.2% of the GPs reported to explore patient’s preferences for treatment. 8 Both percentages are higher as compared to the 15% of the patients for whom this need was met in our study. This might be due to a different study population or due to differences in perception between GPs and patients. Additionally, our results imply that GPs mostly discuss worries and considerations, but are unaware of patients’ needs to discuss the cancer treatment decision itself. Furthermore, our results show that satisfactionwithGP involvement is scored higher if the GP is the initiator of contact. This is supported by findings in a qualitative study by Brandenbarg et al. among curatively treated colorectal cancer patients who expressed dislike when the GP did not initiate contact after treatment. 14 Also, patients’ preference for initiation of contact by the GP is expressed for other conversations, such as for advanced care planning. 15 In addition, previous studies show that patients are more satisfied if the GP is informed about the diagnosis 11 and if there is a contact moment with the GP (a “time out consultation”) before start of treatment. 12 Our findings also support and explain the potential positive effect on SDMof actively involving the GP between diagnosis and therapy choice, which was recently reported for palliatively treated cancer patients. 13 2