Forskningsenheden for Almen Praksis (FEAP)

Background: As gatekeepers in the Danish healthcare system, general practitioners (GPs) perform an important and crucial task in the primary visitation of patients. A challenge for the GPs is to distinguish between symptoms and signs of serious disease among frequently presented complaints. However, little is known about how often and when GPs suspect serious disease in daily practice and whether such suspicion may predict a serious disease.
Research question: The aim of this study was to describe how often GPs in Denmark suspect cancer or other serious diseases following a face-to-face consultation, but also to characterise the patients in whom the suspicion was raised and how the GPs acted upon it. Moreover, an additional aim was to investigate the significance of a suspicion in terms of future serious disease and the patients’ use of health care services.
Methods: A cross-sectional study was performed covering a 12-month period from December 2008 to December 2009 in the Central Denmark Region. The 404 participating GPs were requested to register all patient contacts during one day. The registration form encompassed the question “Are you left with the slightest suspicion of cancer or another serious disease (new)?” These data were combined with registry data regarding subsequent diagnoses and use of healthcare services. Cox regression was used for time-to-diagnosis analyses.
Results: Preliminary findings are: Prevalence of suspicion is 5.7%, incidence of serious diagnoses within 6 months is 3.5%, GP suspicion predicts future serious diagnoses. Further results will be presented.
Discussion: We have new data on how often GPs suspect a serious disease, including cancer, their actions and the prognosis. The results extensively inform us on the importance of a GP in the primary diagnosis of cancer.