Prognosis of cancer in persons with infrequent consultations with their GP

  • Jensen, Henry (Deltager)
  • Vedsted, Peter (Deltager)
  • Møller, Henrik (Projektleder)

Projekter: ProjektForskning



International comparisons have shown variation in short-term survival of cancer. An analysis of colorectal cancer showed that Denmark and England had similar short-term survival deficit when compared with Finland, Norway and Sweden. Studies indicate that Danish patients are diagnosed and treated in a more advanced stage. This may largely be explained by the size of a minority sub-group of cancer patients who come to medical attention with advanced and fatal cancer. The mechanism behind this is not precisely known but it might be that some patients postpone health care seeking.
This study will: (1) estimate the size of the Danish sub-population of people who very rarely consult with their GP, (2) estimate the survival of cancer patients that arise from the sub-group of population with rare GP consultations, and (3) present a sensitivity analysis to estimate the impact on cancer survival in the total population that arise from the hypothesised poor survival in people who infrequently consult their GP.
Recent studies in Denmark and in England shows that patients with cancer tend to have an increased frequency of GP consultations in a period of three to six months before the cancer diagnosis. The identification of persons with cancer who habitually see their GP rarely will therefore focus on the period from 24 months before the cancer diagnosis to 6 months before the cancer diagnosis. It may identify the group of patients that, besides the group having no need for medical help, have a low health care seeking behaviour despite relevant symptoms.
The study will use of a cancer cohort who had their first cancer diagnosis in 2009-2013 in Denmark. A comparison cohort, comprising one age and sex matched subject per cancer case, will be identified. The matched comparison subject will have had no cancer up to the point in time where the cancer cohort member was diagnosed. The data will be extracted from Danish nationwide registers and the analyses will concentrate on the following: (1) detailed comparison of patterns of GP consultation in the cancer cohort and the comparison cohort, (2) comparison of tumour stage distribution in subgroups defined by the habitual GP consultation pattern, (3) cancer-specific and overall survival in the subgroups defined by habitual frequency of GP consultation, and (4) sensitivity analysis of cancer survival by means of a comparison of the survival function in the total cancer cohort and the same cohort after exclusion of the minority of persons with infrequent GP consultations in the period from 24 months before to six months before diagnosis.
Effektiv start/slut dato01/09/201501/10/2019


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