TY - JOUR
T1 - Diagnostic Window Prior to a Haematological Cancer Diagnosis and the Association With Patient Pathways
T2 - A Nationwide Register-Based Cohort Study on Healthcare Utilization in Denmark
AU - Virgilsen, Line Flytkjær
AU - Vedsted, Peter
AU - Jensen, Henry
AU - Frederiksen, Henrik
AU - El-Galaly, Tarec Christoffer
AU - Rasmussen, Linda Aagaard
N1 - Publisher Copyright:
© 2024 The Author(s). European Journal of Haematology published by John Wiley & Sons Ltd.
PY - 2025/2
Y1 - 2025/2
N2 - Objectives: This study investigated healthcare utilisation in general practice and hospitals in the 2 years preceding a diagnosis of haematological cancer and the association with patient pathways. Methods: The nationwide register-based cohort study included 12 994 patients diagnosed with leukaemia, multiple myeloma and lymphoma in 2014–2018 and 10 matched references. Patient pathways were analysed in unplanned routes (acute admission up to 1 month's prior diagnosis) and elective routes (other routes, e.g., cancer patient pathways). Results: Female patients in unplanned diagnostic pathways had more contacts to general practice from 19 months before the diagnosis compared to their matched references; with IRR increasing from 1.14 (95% confidence interval (CI) 1.05–1.24) to 2.27 (95% CI 2.13–2.41) at 30–60 days before the diagnosis. Female patients had more point-of-care tests, hospital contacts and radiological investigations at 17, 24 and 17 months, respectively, before diagnosis compared to their references. Similar patterns were seen for male patients, although with a later onset of increase. No healthcare use variations were seen between patients diagnosed in unplanned versus elective pathways. Conclusions: Increased healthcare utilisation was seen in general practice and hospitals up to 24 months preceding a diagnosis, which may indicate a diagnostic window for detecting haematological cancer earlier.
AB - Objectives: This study investigated healthcare utilisation in general practice and hospitals in the 2 years preceding a diagnosis of haematological cancer and the association with patient pathways. Methods: The nationwide register-based cohort study included 12 994 patients diagnosed with leukaemia, multiple myeloma and lymphoma in 2014–2018 and 10 matched references. Patient pathways were analysed in unplanned routes (acute admission up to 1 month's prior diagnosis) and elective routes (other routes, e.g., cancer patient pathways). Results: Female patients in unplanned diagnostic pathways had more contacts to general practice from 19 months before the diagnosis compared to their matched references; with IRR increasing from 1.14 (95% confidence interval (CI) 1.05–1.24) to 2.27 (95% CI 2.13–2.41) at 30–60 days before the diagnosis. Female patients had more point-of-care tests, hospital contacts and radiological investigations at 17, 24 and 17 months, respectively, before diagnosis compared to their references. Similar patterns were seen for male patients, although with a later onset of increase. No healthcare use variations were seen between patients diagnosed in unplanned versus elective pathways. Conclusions: Increased healthcare utilisation was seen in general practice and hospitals up to 24 months preceding a diagnosis, which may indicate a diagnostic window for detecting haematological cancer earlier.
KW - Denmark
KW - diagnosis
KW - general practice
KW - haematologic neoplasms
KW - hospitals
KW - registries
KW - universal health care
UR - http://www.scopus.com/inward/record.url?scp=85209069362&partnerID=8YFLogxK
U2 - 10.1111/ejh.14315
DO - 10.1111/ejh.14315
M3 - Journal article
C2 - 39533876
AN - SCOPUS:85209069362
SN - 0902-4441
VL - 114
SP - 353
EP - 364
JO - European Journal of Haematology
JF - European Journal of Haematology
IS - 2
ER -