Cancer suspicion, referral to cancer patient pathway and primary care interval: a survey and register study exploring 10 different types of abdominal cancer

General practitioners are often the first port of call for many patients, however, it is unknown whether a GP’s initial cancer suspicion varies for different cancer types and how this is associated with referrals to a standardized cancer patient pathways (CPPs), and the duration of the primary care interval (PCI, time from date of first presentation to a health care practitioner to the date of first referral). This Danish cohort study focused on abdominal cancers, which makes up 30% of all diagnosed cancers. They found that GPs initially suspected cancer or other serious disease in 46–78% of cases, with the lowest rate of suspicions for kidney cancer, and referred 35–65% to a CPP, with the lowest rate for oesophageal cancer. GP’s suspicion at the first presentation was strongly associated with referral to a CPP. The median (0–11 days) and 75th percentile (3–32 days) PCIs varied between the abdominal cancer types, and the likelihood of a longer PCI was more than 3-fold higher when the GP did not initially suspect cancer. These results demonstrate the need for better diagnostic strategies to support GPs to enable effective and efficient referral, and consequently lead to faster diagnosis.

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