Association between GPs' suspicion of cancer and patients' usual consultation pattern in primary care: a cross-sectional study

Patients who rarely consult a GP in the 19-36 months before a cancer diagnosis have more advanced cancer at diagnosis and a worse prognosis. To ensure more timely diagnosis of cancer, the GP should suspect cancer as early as possible. To investigate the GP's suspicion of cancer according to the...

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Bibliographic Details
Published in:British journal of general practice Vol. 69; no. 679; p. e80
Main Authors: Jensen, Henry, Merrild, Camilla Hoffmann, Møller, Henrik, Vedsted, Peter
Format: Journal Article
Language:English
Published: England 01.02.2019
Subjects:
Adult
Aged
Aged, 80 and over
Cross-Sectional Studies
Denmark - epidemiology
Early Detection of Cancer - statistics & numerical data
Female
General Practice
Health Knowledge, Attitudes, Practice
Humans
Male
Middle Aged
Neoplasms - diagnosis
Odds Ratio
Practice Patterns, Physicians' - statistics & numerical data
Referral and Consultation - statistics & numerical data
Registries - statistics & numerical data
Young Adult
Denmark
early diagnosis
Denmark
neoplasms
accessibility of health services
healthcare delivery
general practice
ISSN:1478-5242, 1478-5242
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Summary:Patients who rarely consult a GP in the 19-36 months before a cancer diagnosis have more advanced cancer at diagnosis and a worse prognosis. To ensure more timely diagnosis of cancer, the GP should suspect cancer as early as possible. To investigate the GP's suspicion of cancer according to the patient with cancer's usual consultation pattern in general practice. A cross-sectional study based on survey data from general practice of 3985 Danish patients diagnosed with cancer from May 2010 to August 2010, and linked to national register data. Using logistic regression analysis with restricted cubic splines, the odds ratio (OR) of the GP to suspect cancer as a function of the patient's number of face-to-face consultations with the GP in the 19-36 months before a cancer diagnosis was estimated. GPs' cancer suspicion decreased with higher usual consultation frequency in general practice. A significant decreasing trend in ORs for cancer suspicion was seen across usual consultation categories overall ( <0.001) and for each sex (males: <0.05; females: <0.05). GPs' cancer suspicion was lower in patients aged <55 years in both rare and frequent attenders compared with average attenders. GPs suspect cancer more often in rare attenders ≥55 years. GPs' cancer suspicion was lower in younger patients (<55 years), in both rare and frequent attenders. GPs should be aware of possible missed opportunities for cancer diagnosis in young attenders and use safety netting to reduce the risk of missing a cancer diagnosis.
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ISSN:1478-5242
1478-5242
DOI:10.3399/bjgp19X700769