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dc.contributor.authorMendonca, Silvia Cen
dc.contributor.authorAbel, Gary Aen
dc.contributor.authorLyratzopoulos, Georgiosen
dc.date.accessioned2015-11-16T13:00:14Z
dc.date.available2015-11-16T13:00:14Z
dc.date.issued2016-02-26en
dc.identifier.citationMendonca et al. The British Journal of General Practice (2016). doi: 10.3399/bjgp16X683977en
dc.identifier.issn0960-1643
dc.identifier.urihttps://www.repository.cam.ac.uk/handle/1810/252611
dc.description.abstractBackground Some patients with cancer experience multiple pre-diagnostic consultations in primary care, leading to longer time intervals to specialist investigations and diagnosis. Patients with rarer cancers are thought to be at higher risk of such events, but concrete evidence of this is lacking. Aim To examine the frequency and predictors of repeat consultations with GPs in patients with rarer cancers. Design and setting Patient-reported data on pre-referral consultations from three English national surveys of patients with cancer (2010, 2013, and 2014), pooled to maximise the sample size of rarer cancers. Method The authors examined the frequency and crude and adjusted odds ratios for ≥3 (versus 1–2) pre-referral consultations by age, sex, ethnicity, level of deprivation, and cancer diagnosis (38 diagnosis groups, including 12 rarer cancers without prior relevant evidence). Results Among 7838 patients with 12 rarer cancers, crude proportions of patients with ≥3 pre-referral consultations ranged from >30.0% to 60.0% for patients with small intestine, bone sarcoma, liver, gallbladder, cancer of unknown primary, soft-tissue sarcoma, and ureteric cancer. The range was 15.0–30.0% for patients with oropharyngeal, anal, parotid, penile, and oral cancer. The overall proportion of responders with any cancer who had ≥3 consultations was 23.4%. Multivariable logistic regression indicated concordant patterns, with strong evidence for variation between rarer cancers (P <0.001). Conclusion Patients with rarer cancers experience pre-referral consultations at frequencies suggestive of middle-to-high diagnostic difficulty. The findings can guide the development of new diagnostic interventions and ‘safety-netting’ approaches for symptomatic presentations encountered in patients with rarer cancers.
dc.description.sponsorshipThis work was supported by a Cancer Research UK Clinician Scientist Fellowship (A18180) to GL.
dc.languageEnglishen
dc.language.isoenen
dc.publisherBritish Journal of General Practice
dc.rightsAttribution 2.0 UK: England & Wales
dc.rights.urihttp://creativecommons.org/licenses/by/2.0/uk/
dc.subjectneoplasmen
dc.subjectdiagnosisen
dc.subjectconsultationen
dc.subjectreferralen
dc.subjectinvestigationen
dc.titlePre-referral GP consultations in patients subsequently diagnosed with rarer cancers: a study of patient-reported dataen
dc.typeArticle
dc.description.versionThis is the final version of the article. It first appeared from the British Journal of General Practice via http://dx.doi.org/10.3399/bjgp16X683977en
prism.publicationDate2016en
prism.publicationNameThe British Journal of General Practiceen
dc.rioxxterms.funderCRUK
dc.rioxxterms.projectidA18180
rioxxterms.versionofrecord10.3399/bjgp16X683977en
rioxxterms.licenseref.urihttp://www.rioxx.net/licenses/all-rights-reserveden
rioxxterms.licenseref.startdate2016-02-26en
dc.contributor.orcidLyratzopoulos, Georgios [0000-0002-2873-7421]
dc.identifier.eissn1478-5242
rioxxterms.typeJournal Article/Reviewen
pubs.funder-project-idNational Institute for Health Research (NIHR) (via Cambridgeshire and Peterborough Clinical Commissioning Group (CCG)) (unknown)
cam.orpheus.successThu Jan 30 12:55:34 GMT 2020 - The item has an open VoR version.*
rioxxterms.freetoread.startdate2300-01-01


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Attribution 2.0 UK: England & Wales
Except where otherwise noted, this item's licence is described as Attribution 2.0 UK: England & Wales