BACKGROUND: As part of the \"Cancer Care in the Family Practice\" project sponsored by the German Cancer Aid association, this overview for the first time assesses to what extent general practitioners (GPs) are considered in the formulation of German cancer guidelines.
METHODS: Guidelines relating to cancer care for adult patients were sought in eight national guideline and specialist association portals. Identified guidelines were initially examined to discover whether they referred to health care programmes, which were specifically developed for general practice, whether GPs were involved in their development, and whether GPs were regarded, either directly or at least indirectly, as a target group. Subsequently, all recommendations that were relevant to GPs were assigned to various main categories (communication, treatment measures) as well as subcategories and quantitatively assessed.
RESULTS: Of a total of 559 hits, 29 relevant guidelines were identified, of which 21 clearly referred to cancer care programmes in general practice. Eight guidelines reported that GPs were involved in the development of the guideline, and in four GPs were directly addressed as a target group. The majority of relevant recommendations were assigned to the category \'communication\' but often included recommendations for the implementation of measures that were not directly applicable to family doctors (such as diagnosis and therapy). Relevant recommendations were found mostly in S3 guidelines.
CONCLUSIONS: Not a single cancer guideline mentioned family practice health care programmes, and less than half of them involved family doctors in their development process. Most recommendations from cancer guidelines could not be directly implemented by GPs. The guideline\'s development stage and subject matter (tumour-specific or across all tumour entities) appeared to influence its potential relevance to GPs.

BACKGROUND: Implementation of guidelines in general practice is difficult. Do general practitioners (GPs) reject evidence-based medicine (EBM) in general? Which attitudes do GPs have towards EBM and guidelines, and which value do they attach to EBM in daily routine?
METHODS: We conducted a qualitative study using five focus groups with 53 GPs. The study was set in the German federal states of Bavaria, Saxony, North Rhine-Westphalia, Hesse and Hamburg. Participants were selected according to area (rural/urban), region (North/South, East/West) and grade of professionalisation. Focus groups were digitally recorded and fully transcribed. Data were analysed in a multidisciplinary team using qualitative content analysis.
RESULTS: Most participants felt positive towards EBM. Lack of feasibility was explicitly mentioned: the participants distinguished between \"practised\" and \"true\" EBM. Guidelines are often considered unsuitable for general practice. The GPs felt confident that their treatment of patients was evidence-based.
CONCLUSIONS: Compared to older studies, German GPs have an increasingly favourable opinion about EBM. In order to enhance the practical application of EBM and guidelines the attitudes of GPs need to be considered.