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Peter Vedsted

Ovarian cancer suspicion, urgent referral and time to diagnosis in Danish general practice: a population-based study

Publikation: Bidrag til tidsskrift/Konferencebidrag i tidsskrift /Bidrag til avis › Tidsskriftartikel › Forskning › peer review

DOI

  • Marie-Louise Ladegaard Baun, CaP - Research Centre for Cancer Diagnosis in Primary Care
    • ,
  • Henry Jensen, CaP - Research Centre for Cancer Diagnosis in Primary Care
    • ,
  • Alina Zalounina Falborg
  • Hanne Nørgaard Heje, CaP - Research Centre for Cancer Diagnosis in Primary Care
    • ,
  • Lone Kjeld Petersen, Syddansk Universitet
    • ,
  • Peter Vedsted

BACKGROUND: Ovarian cancer (OC) survival rates are lower in Denmark than in countries with similar health care. Prolonged time to diagnosis could be a contributing factor. The Danish cancer patient pathway (CPP) for OC was introduced in 2009. It provides GPs with fast access to diagnostic work-up.

OBJECTIVE: To investigate cancer suspicion and pathway use among GPs and to explore the association between these factors and the diagnostic intervals (DIs).

METHODS: We conducted a national population-based cohort study using questionnaires and national registers.

RESULTS: Of the 313 women with participating GPs, 91% presented with symptoms within 1 year of diagnosis, 61% presented vague non-specific symptoms and 62% were diagnosed with late-stage disease. Cancer was suspected in 39%, and 36% were referred to a CPP. Comorbidity [prevalence ratio (PR): 0.53, 95% confidence interval (CI): 0.29-0.98] and no cancer suspicion (PR: 0.35, 95% CI: 0.20-0.60) were associated with no referral to a CPP. The median DI was 36 days. Long DIs were associated with no cancer suspicion (median DI: 59 versus 20 days) and no referral to a CPP (median DI: 42 versus 23 days).

CONCLUSIONS: Nine in ten patients attended general practice with symptoms before diagnosis. Two-thirds initially presented with vague non-specific symptoms were less likely to be referred to a CPP and had longer DIs than women suspected of cancer. These findings underline the importance of supplementing the CPP with additional accelerated diagnostic routes.

OriginalsprogEngelsk
TidsskriftFamily Practice
Vol/bind36
Nummer6
Sider (fra-til)751-757
Antal sider7
ISSN1460-2229
DOI
StatusUdgivet - dec. 2019

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