Cancer research in primary care is somewhat different to most of that undertaken by other cancer Trials Groups. In other research groups clinical trials are conducted either for a particular type of cancer, such as breast cancer, melanoma or gynaecological cancer, or they are defined by the type of treatment they are interested in trialling, such as radiation therapy. Primary care however, covers all parts of the body, all types of cancer and numerous health professionals, including but not limited to GPs, physiotherapists and nurses. PC⁴ has identified broad areas within this spectrum of interest that it will address:

• Prevention and screening
• Early diagnosis and management
• Followup care
• Palliative care

Cancer research in primary care also differs from other cancer research in how it undertakes and progresses its research because it must consider its patients in a holistic context within a whole-of-community framework. Much of our research involves the development and evaluation of ‘complex interventions’. These usually involve multiple components which are at various levels from patient to practitioner to health service. Our methods aim to recognise this complexity, and highlight the need to conduct several pre-trial studies before embarking on a full randomised clinical trial of an intervention.

The setting of primary care research is also different to other cancer researchers. Frequently, we need to recruit both the health care professional providing the care and the patient, and the problem is two-fold: the health care professional is usually operating a generalist practice (they see many types of patients), so it is difficult to get sufficient numbers of the one type of patient that your research question is interested in from one site; the researcher has to recruit a large number of health care professionals to get the required number of patients. Secondly, many primary care health professionals work privately, not in government institutions and are in effect operating small businesses; participating in research has an inherent cost in that it takes time, extra time that would not occur in the normal running of that business. We are fortunate that so many of the health professionals in primary care have a truly altruistic philosophy and are committed to contributing to improving cancer outcomes for people in Australia. One such group of GPs is VicReN, the Victorian Primary Care Practice-based Research Network within the Primary Care Research Unit at the University of Melbourne, which is led by our Executive Committee member Prof Jane Gunn. VicReN members with an interest in cancer research will provide some of the sites for PC⁴ studies.