Diagnostic profile characteristics of cancer patients with frequent consultations in primary care before diagnosis

Many patients with common cancers experience diagnostic delay. This case-control study aimed to identify clinical features and consultation profiles of patients who consulted a GP frequently prior to diagnosis. A total of 2570 patients diagnosed with one of the 7 most common cancers in 2011 were selected from the Swedish Cancer Register, along with 9294 controls. Diagnostic codes from primary care for patients with more than 3 GP consultations in the year prior to diagnosis were collected. Likelihood ratios (LRs) were calculated for variables associated with each cancer. More than half of the sample had consulted a GP 4 or more times in the year prior to diagnosis. Alarm symptoms represented 60% of the codes with the highest LR, but only 40% of the 10 most prevalent codes. 17% of the total number of codes had already been registered during the first two GP consultations, and these early clinical features were both alarm symptoms and features with more benign characteristics. These early clinical features that were focal and had benign characteristics could be investigated as possible missed opportunities.

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