Tumour stage and implementation of standardised cancer patient pathways: a comparative cohort study

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Tumour stage and implementation of standardised cancer patient pathways : a comparative cohort study. / Jensen, Henry; Tørring, Marie Louise; Fenger-Grøn, Morten et al.

In: British Journal of General Practice, Vol. 66, No. 647, 01.06.2016, p. 434-443.

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Jensen, Henry ; Tørring, Marie Louise ; Fenger-Grøn, Morten et al. / Tumour stage and implementation of standardised cancer patient pathways : a comparative cohort study. In: British Journal of General Practice. 2016 ; Vol. 66, No. 647. pp. 434-443.

Bibtex

@article{4929caa3dbdc43bea3763d78ba6f0ec4,
title = "Tumour stage and implementation of standardised cancer patient pathways: a comparative cohort study",
abstract = "BACKGROUND: Some European countries have introduced standardised cancer patient pathways (CPPs), including urgent referrals, with the aim of diagnosing cancer at an earlier stage. This is despite a lack of evidence, particularly in patients with symptomatic cancer diagnosed via general practice.AIM: To compare tumour stages in patients with incident cancer diagnosed via general practice before, during, and after CPP implementation in Denmark in 2008-2009.DESIGN AND SETTING: A comparative cohort study of data from GPs and registries on patients with incident cancer listed with a GP before (n = 1420), during (n = 5272), and after (n = 2988) CPP implementation.METHOD: χ(2) test was used to compare stage distributions and logistic regression to estimate odds ratios (OR) of having local cancer after versus before CPP implementation.RESULTS: Distribution of tumour stages did not differ statistically significantly across time (P = 0.494) or between CPP use (P = 0.202). For all cancers combined, the OR of having local cancer after CPP implementation was 0.88 (95% confidence interval [CI] = 0.73 to 1.06) compared with before. For CPP-referred patients, the OR of having local cancer was 0.77 (95% CI = 0.62 to 0.94) compared with all patients before CPP implementation; the corresponding OR for non-CPP-referred patients was 0.96 (95% CI = 0.80 to 1.14).CONCLUSION: No clear tendencies were observed confirming earlier detection of cancer after rather than before CPP implementation. CPP-referred patients had lower odds of having local cancer after CPP implementation than all patients before CPP implementation; this could be because the GPs refer patients who are 'more ill' as urgent referrals.",
author = "Henry Jensen and T{\o}rring, {Marie Louise} and Morten Fenger-Gr{\o}n and Frede Olesen and Jens Overgaard and Peter Vedsted",
note = "{\textcopyright} British Journal of General Practice 2016.",
year = "2016",
month = jun,
day = "1",
doi = "10.3399/bjgp16X684805",
language = "English",
volume = "66",
pages = "434--443",
journal = "British Journal of General Practice",
issn = "0960-1643",
publisher = "Royal College of General Practitioners",
number = "647",

}

RIS

TY - JOUR

T1 - Tumour stage and implementation of standardised cancer patient pathways

T2 - a comparative cohort study

AU - Jensen, Henry

AU - Tørring, Marie Louise

AU - Fenger-Grøn, Morten

AU - Olesen, Frede

AU - Overgaard, Jens

AU - Vedsted, Peter

N1 - © British Journal of General Practice 2016.

PY - 2016/6/1

Y1 - 2016/6/1

N2 - BACKGROUND: Some European countries have introduced standardised cancer patient pathways (CPPs), including urgent referrals, with the aim of diagnosing cancer at an earlier stage. This is despite a lack of evidence, particularly in patients with symptomatic cancer diagnosed via general practice.AIM: To compare tumour stages in patients with incident cancer diagnosed via general practice before, during, and after CPP implementation in Denmark in 2008-2009.DESIGN AND SETTING: A comparative cohort study of data from GPs and registries on patients with incident cancer listed with a GP before (n = 1420), during (n = 5272), and after (n = 2988) CPP implementation.METHOD: χ(2) test was used to compare stage distributions and logistic regression to estimate odds ratios (OR) of having local cancer after versus before CPP implementation.RESULTS: Distribution of tumour stages did not differ statistically significantly across time (P = 0.494) or between CPP use (P = 0.202). For all cancers combined, the OR of having local cancer after CPP implementation was 0.88 (95% confidence interval [CI] = 0.73 to 1.06) compared with before. For CPP-referred patients, the OR of having local cancer was 0.77 (95% CI = 0.62 to 0.94) compared with all patients before CPP implementation; the corresponding OR for non-CPP-referred patients was 0.96 (95% CI = 0.80 to 1.14).CONCLUSION: No clear tendencies were observed confirming earlier detection of cancer after rather than before CPP implementation. CPP-referred patients had lower odds of having local cancer after CPP implementation than all patients before CPP implementation; this could be because the GPs refer patients who are 'more ill' as urgent referrals.

AB - BACKGROUND: Some European countries have introduced standardised cancer patient pathways (CPPs), including urgent referrals, with the aim of diagnosing cancer at an earlier stage. This is despite a lack of evidence, particularly in patients with symptomatic cancer diagnosed via general practice.AIM: To compare tumour stages in patients with incident cancer diagnosed via general practice before, during, and after CPP implementation in Denmark in 2008-2009.DESIGN AND SETTING: A comparative cohort study of data from GPs and registries on patients with incident cancer listed with a GP before (n = 1420), during (n = 5272), and after (n = 2988) CPP implementation.METHOD: χ(2) test was used to compare stage distributions and logistic regression to estimate odds ratios (OR) of having local cancer after versus before CPP implementation.RESULTS: Distribution of tumour stages did not differ statistically significantly across time (P = 0.494) or between CPP use (P = 0.202). For all cancers combined, the OR of having local cancer after CPP implementation was 0.88 (95% confidence interval [CI] = 0.73 to 1.06) compared with before. For CPP-referred patients, the OR of having local cancer was 0.77 (95% CI = 0.62 to 0.94) compared with all patients before CPP implementation; the corresponding OR for non-CPP-referred patients was 0.96 (95% CI = 0.80 to 1.14).CONCLUSION: No clear tendencies were observed confirming earlier detection of cancer after rather than before CPP implementation. CPP-referred patients had lower odds of having local cancer after CPP implementation than all patients before CPP implementation; this could be because the GPs refer patients who are 'more ill' as urgent referrals.

U2 - 10.3399/bjgp16X684805

DO - 10.3399/bjgp16X684805

M3 - Journal article

C2 - 27025558

VL - 66

SP - 434

EP - 443

JO - British Journal of General Practice

JF - British Journal of General Practice

SN - 0960-1643

IS - 647

ER -