Possible missed opportunities for diagnosing colorectal cancer in Dutch primary care

This multi-methods study, including quantitative and qualitative data, aimed to further understand the diagnostic process of colorectal cancer (CRC) in general practice. Healthcare use in the year before referral for colonoscopy was analysed between patients diagnosed with CRC compared with a GP-matched control population. Patients with CRC had 41% more face-to-face contacts and 21% more medication prescriptions than controls. 46% of patients with CRC had two or more contacts for digestive reasons, compared with 12.2% of controls. The qualitative analysis identified ‘possible missed diagnostic opportunities’, relating to patients waiting before presenting symptoms, doctors attributing symptoms to comorbidities or doctors sticking to an original diagnosis. Although in many cases the diagnostic trajectory in primary care may not be expedited, there are pitfalls highlighted in this study that GPs need to be aware of which could reduce missed opportunities and aid a timely diagnosis.

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