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Objective: To assess the effect on time to diagnosis of recurrence and on quality of life of transferring primary responsibility for follow up of women with breast cancer in remission from hospital to general practice.

Design: Randomised controlled trial with 18 month follow up in which women received routine follow up either in hospital or in general practice.

Subjects and setting: 296 women with breast cancer in remission receiving regular follow up care at district general hospitals in England.

Main outcome measures: Time between first presentation of symptoms to confirmation of recurrence; quality of life measured by specific dimensions of the SF-36 schedule, the EORTC symptom scale, and hospital anxiety and depression scale.

Results: Most recurrences (18/26, 69%) presented as interval events, and almost half (7/16, 44%) of the recurrences in the hospital group presented first to general practice. The median …