Diagnostic intervals before and after implementation of cancer patient pathways - a GP survey and registry based comparison of three cohorts of cancer patients

Henry Jensen; Marie Louise Tørring; Frede Olesen; Jens Overgaard; Morten Fenger-Grøn; Peter Vedsted

doi:10.1186/s12885-015-1317-7

Diagnostic intervals before and after implementation of cancer patient pathways - a GP survey and registry based comparison of three cohorts of cancer patients

Henry Jensen, Marie Louise Tørring, Frede Olesen, Jens Overgaard, Morten Fenger-Grøn, Peter Vedsted

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

Abstract

Dette studie undersøger, om det diagnostiske interval – dvs. tiden fra første kontakt med praktiserende læge til datoen for diagnosen – var kortere efter (end før og under) indførelsen af kræftpakkeforløb . Resultaterne viser, at det diagnostiske interval i gennemsnit var henholdsvis 14 dage kortere i 2007/08 og 17 dage kortere i 2010 ift. før kræftpakkerne. For de 10 % af patienterne, der ventede længst på deres diagnose, var det diagnostiske interval henholdsvis 53 dage kortere i 2007/08 og 44 dage kortere i 2010 ift. før kræftpakkerne. I 2010 var det diagnostiske interval i gennemsnit henholdsvis 23 dage kortere for de pakkehenviste og 9 dage kortere for ikke-pakkehenviste ift. alle patienter før kræftpakkerne. For de 10 % af patienterne, der ventede længst på deres diagnose, var de tilsvarende tal 110 dage kortere for pakkehenviste og 6 dage længere for ikke-pakkehenviste. Analyser for de enkelte kræfttyper viste samme tendenser. Forfatterne konkluderer derfor, at det diagnostiske interval er blevet kortere efter indførelsen af kræftpakkerne, men at de patienter, der ikke blev henvist til en kræftpakke i 2010, stadig havde et langt diagnostisk interval – næsten som før kræftpakkerne. Selvom et af målene med kræftpakkerne var at give hurtigere udredning til alle kræftpatienter, synes der at være behov for yderligere tiltag, som særligt er målrettet de patienter, der ikke henvises direkte til et pakkeforløb for en bestemt kræfttype. Studiet sammenligner tre CaP-kohorter (2004/05, 2007/08 og 2010 ) af nydiagnosticerede førstegangskræftpatienter. Data blev indsamlet via spørgeskemaer til de praktiserende læger, og disse data blev koblet til registre. Svarprocenten fra lægerne var 79,2 %, og i alt 12.558 patienter er indkluderet i analyserne.

Originalsprog	Engelsk
Tidsskrift	BMC Cancer
Vol/bind	15
Nummer	1
Sider (fra-til)	308
ISSN	1471-2407
DOI	https://doi.org/10.1186/s12885-015-1317-7
Status	Udgivet - 23 apr. 2015

Adgang til dokumentet

10.1186/s12885-015-1317-7

Diagnosing Cancer and ‘fast track’ referral in Primary Care. – Studies of symptom interpretation, time to diagnosis and tumour stages.
Jensen, H. (Deltager), Tørring, M. L. (Deltager), Olesen, F. (Deltager) & Vedsted, P. (Deltager)
01/03/2012 → 24/06/2015
Projekter: Projekt › Forskning

1 Deltagelse i eller organisering af workshop, seminar eller kursus
1 Foredrag og mundtlige bidrag

Implementation of cancer patient pathways and the association with more timely diagnosis and earlier detection of cancer among incident cancer patients in primary care: PhD Defence
Jensen, H. (Foredragsholder)
24 jun. 2015
Aktivitet: Tale eller præsentation - typer › Foredrag og mundtlige bidrag
DMCG.dk og Kræftens Bekæmpelses konference 2015
Jensen, H. (Deltager)
5 mar. 2015
Aktivitet: Deltagelse i eller arrangement af en begivenhed - typer › Deltagelse i eller organisering af workshop, seminar eller kursus

The Fogh Nielsen Legacy - Second Prize
Jensen, H. (Modtager), 23 jan. 2015
Pris: Priser, stipendier, udnævnelser

Citationsformater

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title = "Diagnostic intervals before and after implementation of cancer patient pathways - a GP survey and registry based comparison of three cohorts of cancer patients",

abstract = "BACKGROUND: From 2008, Danish general practitioners could refer patients suspected of having cancer to standardised cancer patient pathways (CPPs). We aimed to compare the length of the diagnostic interval in 2010 with the length of the diagnostic interval before (2004/05) and during (2007/08) the implementation of CPPs in Denmark for all incident cancer patients who attended general practice prior to the cancer diagnosis.METHODS: General practitioner questionnaires and register data on 12,558 patients were used to compare adjusted diagnostic interval across time by quantile regression.RESULTS: The median diagnostic interval was 14 (95%CI: 11;16) days shorter during and 17 (95%CI: 15;19) days shorter after the implementation of CPPs than before. The diagnostic interval was 15 (95%CI: 12;17) days shorter for patients referred to a CPP in 2010 than during the implementation, whereas patients not referred to a CPP in 2010 had a 4 (95%CI: 1;7) days longer median diagnostic interval; the pattern was similar, but larger at the 75(th) and 90(th) percentiles.CONCLUSION: The diagnostic interval was significantly lower after CPP implementation. Yet, patients not referred to a CPP in 2010 tended to have a longer diagnostic interval compared to during the implementation. CPPs may thus only seem to expedite the diagnostic process for some cancer patients.",

author = "Henry Jensen and T{\o}rring, {Marie Louise} and Frede Olesen and Jens Overgaard and Morten Fenger-Gr{\o}n and Peter Vedsted",

year = "2015",

month = apr,

day = "23",

doi = "10.1186/s12885-015-1317-7",

language = "English",

volume = "15",

pages = "308",

journal = "BMC Cancer",

issn = "1471-2407",

publisher = "BioMed Central Ltd.",

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Diagnostic intervals before and after implementation of cancer patient pathways - a GP survey and registry based comparison of three cohorts of cancer patients. / Jensen, Henry; Tørring, Marie Louise ; Olesen, Frede et al.
I: BMC Cancer, Bind 15, Nr. 1, 23.04.2015, s. 308.

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

TY - JOUR

T1 - Diagnostic intervals before and after implementation of cancer patient pathways - a GP survey and registry based comparison of three cohorts of cancer patients

AU - Jensen, Henry

AU - Tørring, Marie Louise

AU - Olesen, Frede

AU - Overgaard, Jens

AU - Fenger-Grøn, Morten

AU - Vedsted, Peter

PY - 2015/4/23

Y1 - 2015/4/23

N2 - BACKGROUND: From 2008, Danish general practitioners could refer patients suspected of having cancer to standardised cancer patient pathways (CPPs). We aimed to compare the length of the diagnostic interval in 2010 with the length of the diagnostic interval before (2004/05) and during (2007/08) the implementation of CPPs in Denmark for all incident cancer patients who attended general practice prior to the cancer diagnosis.METHODS: General practitioner questionnaires and register data on 12,558 patients were used to compare adjusted diagnostic interval across time by quantile regression.RESULTS: The median diagnostic interval was 14 (95%CI: 11;16) days shorter during and 17 (95%CI: 15;19) days shorter after the implementation of CPPs than before. The diagnostic interval was 15 (95%CI: 12;17) days shorter for patients referred to a CPP in 2010 than during the implementation, whereas patients not referred to a CPP in 2010 had a 4 (95%CI: 1;7) days longer median diagnostic interval; the pattern was similar, but larger at the 75(th) and 90(th) percentiles.CONCLUSION: The diagnostic interval was significantly lower after CPP implementation. Yet, patients not referred to a CPP in 2010 tended to have a longer diagnostic interval compared to during the implementation. CPPs may thus only seem to expedite the diagnostic process for some cancer patients.

AB - BACKGROUND: From 2008, Danish general practitioners could refer patients suspected of having cancer to standardised cancer patient pathways (CPPs). We aimed to compare the length of the diagnostic interval in 2010 with the length of the diagnostic interval before (2004/05) and during (2007/08) the implementation of CPPs in Denmark for all incident cancer patients who attended general practice prior to the cancer diagnosis.METHODS: General practitioner questionnaires and register data on 12,558 patients were used to compare adjusted diagnostic interval across time by quantile regression.RESULTS: The median diagnostic interval was 14 (95%CI: 11;16) days shorter during and 17 (95%CI: 15;19) days shorter after the implementation of CPPs than before. The diagnostic interval was 15 (95%CI: 12;17) days shorter for patients referred to a CPP in 2010 than during the implementation, whereas patients not referred to a CPP in 2010 had a 4 (95%CI: 1;7) days longer median diagnostic interval; the pattern was similar, but larger at the 75(th) and 90(th) percentiles.CONCLUSION: The diagnostic interval was significantly lower after CPP implementation. Yet, patients not referred to a CPP in 2010 tended to have a longer diagnostic interval compared to during the implementation. CPPs may thus only seem to expedite the diagnostic process for some cancer patients.

U2 - 10.1186/s12885-015-1317-7

DO - 10.1186/s12885-015-1317-7

M3 - Journal article

C2 - 25900050

SN - 1471-2407

VL - 15

SP - 308

JO - BMC Cancer

JF - BMC Cancer

IS - 1

ER -

Diagnostic intervals before and after implementation of cancer patient pathways - a GP survey and registry based comparison of three cohorts of cancer patients

Abstract

Adgang til dokumentet

Fingeraftryk

Projekter

Diagnosing Cancer and ‘fast track’ referral in Primary Care. – Studies of symptom interpretation, time to diagnosis and tumour stages.

Aktiviteter

Implementation of cancer patient pathways and the association with more timely diagnosis and earlier detection of cancer among incident cancer patients in primary care: PhD Defence

DMCG.dk og Kræftens Bekæmpelses konference 2015

Priser

The Fogh Nielsen Legacy - Second Prize

Citationsformater