The Danish cancer pathway for patients with serious non-specific symptoms and signs of cancer-a cross-sectional study of patient characteristics and cancer probability
| Autor: | Flemming Bro, Mads Lind Ingeman, Søren Tang Knudsen, Peter Vedsted, Morten Bondo Christensen |
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| Jazyk: | angličtina |
| Rok vydání: | 2015 |
| Předmět: |
Adult
Male medicine.medical_specialty Cancer Research Referral Adolescent Colorectal cancer Cross-sectional study Denmark Population Young Adult Pancreatic cancer Internal medicine Neoplasms Surveys and Questionnaires Diagnosis medicine Genetics Humans Fast-track Young adult Lung cancer education Referral and Consultation Aged Aged 80 and over education.field_of_study business.industry Cancer Middle Aged medicine.disease Cross-Sectional Studies Oncology Physical therapy Neoplasm Female Symptom Assessment business General practice Cancer symptoms Research Article |
| Zdroj: | Ingeman, M L, Christensen, M B, Bro, F, Knudsen, S T & Vedsted, P 2015, ' The Danish cancer pathway for patients with serious non-specific symptoms and signs of cancer-a cross-sectional study of patient characteristics and cancer probability ', BMC Cancer, vol. 15, no. 1, pp. 421 . https://doi.org/10.1186/s12885-015-1424-5 BMC Cancer |
| DOI: | 10.1186/s12885-015-1424-5 |
| Popis: | Denne artikel ser nærmere på, hvilke patienter der bliver henvist til ”kræftpakken for alvorlig sygdom, der kunne være kræft”, og hvor stor risikoen er for, at de henviste har kræft. Resultaterne viser, at 16,2 % af alle de henviste, som blev inkluderet i studiet, havde kræft. De mest udbredte kræftformer var lungekræft (17,9 %), tarmkræft (12,6 %), blodkræft (10,1 %) og kræft i bugspytkirtlen (9,2 %). I alt havde patienterne over 80 forskellige symptomer og 51 forskellige kliniske fund på henvisningstidspunktet. De fleste symptomer var uspecifikke og vage, fx var vægttab og træthed noteret i over halvdelen af henvisningerne. De tre mest hyppige kliniske fund var ”påvirket almentilstand” (35,8 %), lægens ”mavefornemmelse” (22,5 %) og ”fund i maveregionen” (13,0 %). Der var en stærk sammenhæng mellem den praktiserende læges vurdering af patientens kræftrisiko på henvisningstidspunktet og sandsynligheden for, at patienten havde kræft. Studiet er gennemført som et tværsnitsstudie og bygger på data fra alle de patienter, der blev henvist til ”kræftpakken for alvorlig sygdom, der kunne være kræft” på hospitalerne i Silkeborg og Aarhus i perioden marts 2012 – marts 2013. Data er indsamlet via spørgeskemaer, som er udfyldt af patienternes praktiserende læge, og denne information er kombineret med registerdata. BACKGROUND: A Danish cancer pathway has been implemented for patients with serious non-specific symptoms and signs of cancer (NSSC-CPP). The initiative is one of several to improve the long diagnostic interval and the poor survival of Danish cancer patients. However, little is known about the patients investigated under this pathway. We aim to describe the characteristics of patients referred from general practice to the NSSC-CPP and to estimate the cancer probability and distribution in this population.METHODS: A cross-sectional study was performed, including all patients referred to the NSSC-CPP at the hospitals in Aarhus or Silkeborg in the Central Denmark Region between March 2012 and March 2013. Data were based on a questionnaire completed by the patient's general practitioner (GP) combined with nationwide registers. Cancer probability was the percentage of new cancers per investigated patient. Associations between patient characteristics and cancer diagnosis were estimated with prevalence rate ratios (PRRs) from a generalised linear model.RESULTS: The mean age of all 1278 included patients was 65.9 years, and 47.5 % were men. In total, 16.2 % of all patients had a cancer diagnosis after six months; the most common types were lung cancer (17.9 %), colorectal cancer (12.6 %), hematopoietic tissue cancer (10.1 %) and pancreatic cancer (9.2 %). All patients in combination had more than 80 different symptoms and 51 different clinical findings at referral. Most symptoms were non-specific and vague; weight loss and fatigue were present in more than half of all cases. The three most common clinical findings were 'affected general condition' (35.8 %), 'GP's gut feeling' (22.5 %) and 'findings from the abdomen' (13.0 %). A strong association was found between GP-estimated cancer risk at referral and probability of cancer.CONCLUSIONS: In total, 16.2 % of the patients referred through the NSSC-CPP had cancer. They constituted a heterogeneous group with many different symptoms and clinical findings. The GP's gut feeling was a common reason for referral which proved to be a strong predictor of cancer. The GP's overall estimation of the patient's risk of cancer at referral was associated with the probability of finding cancer. |
| Databáze: | OpenAIRE |
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