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- Title
Ovarian cancer suspicion, urgent referral and time to diagnosis in Danish general practice: a population-based study.
- Authors
Baun, Marie-Louise L; Jensen, Henry; Falborg, Alina Z; Heje, Hanne N; Petersen, Lone K; Vedsted, Peter
- Abstract
<bold>Background: </bold>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.<bold>Objective: </bold>To investigate cancer suspicion and pathway use among GPs and to explore the association between these factors and the diagnostic intervals (DIs).<bold>Methods: </bold>We conducted a national population-based cohort study using questionnaires and national registers.<bold>Results: </bold>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).<bold>Conclusions: </bold>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.
- Subjects
DENMARK; OVARIAN cancer; SUSPICION; DIAGNOSIS; MEDICAL care; CONFIDENCE intervals
- Publication
Family Practice, 2019, Vol 36, Issue 6, p751
- ISSN
0263-2136
- Publication type
journal article
- DOI
10.1093/fampra/cmz013