PhD defence J.G. (Josine) Kuiper

Dissertation in short:

The number of patients newly diagnosed with colorectal cancer is increasing. Due to early detection and innovations in colorectal cancer treatment, the survival of patients diagnosed with colorectal cancer has been improved over the last years. As a result, more patients are confronted with the late effects of cancer treatment which can manifest many years after completion of the treatment. The general practitioner is the gatekeeper in the Dutch healthcare system and involved in different stages of the disease: from prevention to end-of-life care. At the moment, there is limited insight into the utilisation of primary care among colorectal cancer patients. These insights are essential in order to detect potentials for early detection of cancer and will provide knowledge on the late effects of cancer for which patients consulted their general practitioner. Furthermore, having information on the use of certain drugs among cancer patients will inform on potential associations between drug use and the occurrence of cancer. This thesis aimed to get more insight into the utilisation of primary care among colorectal cancer patients, including their healthcare seeking behaviour before diagnosis, the effect of its pharmacological treatment on the occurrence of heart failure, and associations between drug use and the risk of colorectal cancer.