Alignment between the patient’s cancer worry and the GP’s cancer suspicion and the association with the interval between first symptom presentation and referral: a cross-sectional study in Denmark

BMC Family Practice

Gitte Stentebjerg Petersen¹  Line Flytkjær Virgilsen²  Henry Jensen²  Anette Fischer Pedersen³  Peter Vedsted³ 

[1] Danish Cancer Society, Strandboulevarden 49,, 2100, København Ø, Denmark;Research Centre for Cancer Diagnosis in Primary Care, Research Unit for General Practice, Bartholins Allé 2, 8000, Aarhus C, Denmark;Research Centre for Cancer Diagnosis in Primary Care, Research Unit for General Practice, Bartholins Allé 2, 8000, Aarhus C, Denmark;Department of Clinical Medicine, Aarhus University, Palle Juul-Jensens Boulevard 82, 8200, Aarhus C, Denmark;

关键词: Neoplasms;    Denmark;    General practice;    Early diagnosis;    Primary health care;    Signs and symptoms;   

DOI  :  10.1186/s12875-021-01480-2

来源: Springer

【 摘 要 】

BackgroundGeneral practitioners (GPs) have a key role in the diagnosis of cancer. It is crucial to identify factors influencing the decision to refer for suspected cancer. The aim of this study was to investigate the alignment between the patient’s cancer worry and the GP’s suspicion of cancer in the first clinical encounter and the association with the time interval from the first symptom presentation until the first referral to specialist care, i.e. the primary care interval (PCI).MethodThe study was performed as a cross-sectional study using survey data on patients diagnosed with incident cancer in 2010 or 2016 and their GPs in Denmark. We defined four alignment groups: 1) patient worry and GP suspicion, 2)  GP suspicion only, 3) patient worry only, and 4) none of the two. A long PCI was defined as an interval longer than the 75th percentile.ResultsAmong the 3333 included patients, both patient worry and GP suspicion was seen in 39.5%, only GP suspicion was seen in 28.2%, only patient worry was seen in 13.6%, and neither patient worry nor GP suspicion was seen in 18.2%. The highest likelihood of long PCI was observed in group 4 (group 4 vs. group 1: PPR 3.99 (95% CI 3.34–4.75)), mostly pronounced for easy-to-diagnose cancer types.ConclusionMisalignment between the patient’s worry and the GP’s suspicion was common at the first cancer-related encounter. Importance should be given to the patient interview, due to a potential delayed GP referral among patients diagnosed with “easy-to-diagnose” cancer types presenting with unspecific symptoms.

【 授权许可】

CC BY