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Peter Vedsted

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

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Ovarian cancer suspicion, urgent referral and time to diagnosis in Danish general practice: a population-based study. / Baun, Marie-Louise Ladegaard; Jensen, Henry; Falborg, Alina Zalounina; Heje, Hanne Nørgaard; Petersen, Lone Kjeld; Vedsted, Peter.

I: Family Practice, Bind 36, Nr. 6, 12.2019, s. 751-757.

Publikation: Bidrag til tidsskrift/Konferencebidrag i tidsskrift /Bidrag til avisTidsskriftartikelForskningpeer review

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@article{c4858e9eb6de4022b66599c9d9d4ddba,
title = "Ovarian cancer suspicion, urgent referral and time to diagnosis in Danish general practice:: a population-based study",
abstract = "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.",
author = "Baun, {Marie-Louise Ladegaard} and Henry Jensen and Falborg, {Alina Zalounina} and Heje, {Hanne N{\o}rgaard} and Petersen, {Lone Kjeld} and Peter Vedsted",
year = "2019",
month = "12",
doi = "10.1093/fampra/cmz013",
language = "English",
volume = "36",
pages = "751--757",
journal = "Family Practice",
issn = "0263-2136",
publisher = "Oxford University Press",
number = "6",

}

RIS

TY - JOUR

T1 - Ovarian cancer suspicion, urgent referral and time to diagnosis in Danish general practice:

T2 - a population-based study

AU - Baun, Marie-Louise Ladegaard

AU - Jensen, Henry

AU - Falborg, Alina Zalounina

AU - Heje, Hanne Nørgaard

AU - Petersen, Lone Kjeld

AU - Vedsted, Peter

PY - 2019/12

Y1 - 2019/12

N2 - 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.

AB - 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.

U2 - 10.1093/fampra/cmz013

DO - 10.1093/fampra/cmz013

M3 - Journal article

C2 - 31046091

VL - 36

SP - 751

EP - 757

JO - Family Practice

JF - Family Practice

SN - 0263-2136

IS - 6

ER -